Breast carcinoma presenting as chondrosternal thickening: A long-standing masquerade

The internal mammary lymphatics are the second most common site of regional metastasis in breast carcinoma. However, because of their retrosternal location, they rarely become clinically evident. This report describes a patient with a parasternal breast carcinoma metastasis arising from internal mammary lymphatics. The metastasis caused symptoms for more than 3 years before the primary tumor was discovered. The pathologic elements underlying this unusual presentation along with the treatment options and the surgical management with extended mastectomy are discussed in detail.