title: An unusual cause of dysphagia in ductal breast cancer due to submucosal oropharyngeal metastatic spread: a case report.
abstract: BACKGROUND
  Invasive ductal and lobular carcinomas represent 67.9% and 6.3% of breast carcinoma, respectively. Metastatic breast cancer typically involves the lungs, bones, brain, and liver. Studies have shown differing patterns of metastatic spread between ductal and lobular carcinoma. Lobular carcinoma is more likely to metastasise to the gastrointestinal tract.
  
  
  METHODS
  We report the case of a 49 year old white woman with invasive ductal carcinoma with lobular differentiation who developed submucosal oropharyngeal metastases nearly two years after her original diagnosis after presenting with odynophagia and dysphagia. The patient's symptoms preceded any associated radiological or endoscopic abnormalities by at least 9 months. Repeat computed tomography scan and eventual oropharyngeal biopsy confirmed submucosal metastatic invasive ductal carcinoma, suggesting occult submucosal spread.
  
  
  CONCLUSIONS
  This case illustrates the importance of maintaining a high index of suspicion for metastatic disease in patients with invasive breast cancer who present with unusual symptoms and a careful search for metastatic sites.
authors.affiliation: Sussex Cancer Centre, Royal Sussex County Hospital, Eastern Rd, Brighton, BN2 5BE, UK. gjrdor001@yahoo.com.
authors.forename: Dorothy M
authors.initials: DM
authors.lastname: Gujral
authors.forename: Mara
authors.initials: M
authors.lastname: Quante
authors.forename: Richard Aj
authors.initials: RA
authors.lastname: Simcock