# Invasive ductal carcinoma of the breast with gallbladder metastasis: a rare case report

## TL;DR

A rare case of breast cancer spreading to the gallbladder is reported, highlighting the need for vigilance in patients with a history of breast cancer.

## Contribution

This case report documents an exceptionally rare metastasis of invasive ductal breast cancer to the gallbladder.

## Key findings

- Breast cancer metastasis to the gallbladder is exceptionally rare, especially from ductal origin.
- Late metastasis occurred despite initial treatment and lack of surveillance.
- The patient's symptoms of cholecystitis could have indicated gallbladder metastasis.

## Abstract

Invasive ductal carcinoma of the breast most commonly metastasizes to bone, lung, liver, and central nervous system. Breast cancer metastasis to the gallbladder is exceptionally rare, especially when it is secondary to breast cancer of ductal origin.

We present the case of a pre-menopausal 43-year-old female with a history of major depressive disorder and no prior mammograms who was diagnosed with ER+/PR+/HER2+ invasive ductal carcinoma of the right breast. She developed late metastasis to the gallbladder, liver, lung and bone detected four years after breast conserving surgery with delayed neoadjuvant chemotherapy, adjuvant radiation, incomplete adjuvant biologic and hormone therapy, and lack of surveillance. The patient died three years and ten months after her lumpectomy.

Though rare, adequate suspicion should be maintained when evaluating patients with a history of breast cancer who present with symptoms of cholecystitis or biliary colic in order to promptly identify breast cancer metastasis to the gallbladder, as well as to more common metastatic sites.