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The patient was subsequently referred to a palliative care team and the patient decided to go for home hospice care. Figure 3 Ultrasonography image of the right breast showing 1.4?cm �� 1.2?cm irregularly shaped, speculated, hypoechoic lesion with central necrotic changes and high vascularity. 3. Discussion Colorectal carcinoma is the third most common cancer among men and women with an estimated number of 71,830 reported new cases in men and 65,000 new cases in women [7]. The most common sites of spread include locoregional lymph nodes, liver, lungs, and bone in descending order [1]. It is rare to find metastasis of colonic adenocarcinoma to the breast MS275 [5, 6]. The incidence of metastasis in breast from extramammary sites was 6.6% to 7% in autopsy studies [8]. The most common tumor that metastasizes to the breast is a contralateral breast carcinoma, followed by metastasis from hematopoietic neoplasms, malignant melanoma, lymphoma, sarcoma, lung, prostate, ovary, kidney, stomach, and carcinoid tumors [1, 3�C5, 9]. In the published literature, there are very few reported cases of colorectal cancer that metastasized to the breast, and these are mainly seen in the settings of concomitant liver and lung metastasis [9]. The median age at which breast metastasis present GDC-0449 manufacturer is 54 years, and it is much more commonly found in women than in men (5�C8%) [5, 6, 8]. The average time interval to develop metastatic lesions in the breast from a primary source is about two Quinapyramine years [5]. These findings were consistent with the patients presented in this report as they were women aged 45 and 56, respectively. The commonly known explanation for metastasis involves the spread of cells from the primary tumor via lymphatic, hematogenous, or transcoelomic spread. This model does not explain the finding of a metastatic lesion in the breast as the only site of spread [10]. A second hypothesis was proposed by Mihai et al., suggesting that when cancer cells undergo apoptosis, small fragments of genome may be released, enter circulation, enter other cells of the reticuloendothelial system, and maybe even enter normal cells via the route of transinfection [10]. Morphologically, metastases to the breast tend to show certain characteristics, including a periductal and perilobular location, lack of an in situ ductal or lobular component, and the absence of a desmoplastic reaction [6, 11]. They tend to have rapid growth and be palpable mobile masses and are not associated with any skin dimpling, nipple retraction, or bloody nipple discharge [1, 6, 11]. They are slightly more common in the left breast and tend to be found in the upper outer quadrant [4]. Neither patient presented in this report was found to have any nipple discharge or retraction. Case 2 presented with a palpable mass in one breast, although Case 1 did not have any masses present at all.