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CASE REPORT

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

Teng Zhu1,#, Siwen Zang2,#, Bo Chen1,*
1 Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
2 Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
* Corresponding Author: Bo Chen. Email: chenbo@gdph.org.cn
# The two authors contributed equally to this work

Oncology Research https://doi.org/10.32604/or.2026.067876

Received 15 May 2025; Accepted 29 December 2025; Published online 03 April 2026

Abstract

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.

Keywords

Orbital metastasis; breast cancer; navigation-assisted biopsy; palliative therapy; skeletal metastases; case report

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