Orbital Metastases of Breast Cancer:Case Report and Review of the LiteratureOA

Background:Orbital metastases are rare in breast cancer,representing only 3–10%of ocular metastases.This report highlights a case where orbital involvement was the first indicator of systemic metastatic spread.Case Presentation:A 72-year-old woman with a history of Estrogen Receptor(ER)-positive(5%),Progesterone Receptor(PR)-negative,Human epidermal growth factor receptor-2(HER2)-negative breast cancer(diagnosed 3 years prior)presented with right orbital pain,diplopia,and periorbital swelling.Imaging revealed multiple myositis of the extraocular muscles,compressive displacement of the optic nerve,and right periorbital edema.Bone scintigraphy identified multifocal skeletal metastases.A navigation-assisted biopsy confirmed metastatic invasive ductal carcinoma,immunohistochemically consistent with the primary tumor(ER/PR-negative,HER2-negative).A systematic analysis using next-generation sequencing indicated aberrant activation of the phosphoinositide 3 kinase(PI3K)/AKT/mammalian target of rapamycin(mTOR)signaling pathway.Chemotherapy,targeted therapy and bisphosphonate therapy were initiated,with planned radiotherapy for symptomatic progression.Conclusion:Orbital symptoms in breast cancer survivors,even subtle ones,necessitate prompt evaluation for metastatic disease.Multimodal imaging(e.g.,Computed Tomography(CT)/Magnetic Resonance Imaging(MRI))combined with image-guided biopsy is critical for diagnosis.Early detection enables multidisciplinary palliative strategies to optimize quality of life while addressing systemic dissemination.