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cytology. *a3v5 FNA of a metastatic breast cancer represents a diagnostic challenge to the cytopathologist to differentiate it from a primary breast cancer. We report seven FNAs from six patients with metastatic ovarian cancer to the breast. Its clinicopathologic and cytomorphologic features are described and compared to those reported in the literature. Materials and MethodsSeven FNAs were performed on six patients with metastatic ovarian cancer to the breast at the University of Pittsburgh Medical Center and Magee-Womens Hospital (MWH) between 1991 and 1994. The needle aspirates were performed by surgeons using 21-or 22-gauge needles. The aspirates were smeared, alcohol-fixed, and stained with Papanicolaou technique using the previously described techniques. ' Air-dried smears were prepared and stained with Diff-Quik (Baxter, Pittsburgh, PA). Cell blocks (available on three cases) were prepared using a previously described technique and were stained with hematoxylin-eosin (H&E). Special stains and immunohistochemical staining were performed on selected cases.The medical records as well as the original histology from the primary ovarian tumor and breast metastases (when a biopsy was performed) were reviewed. ResultsThe incidence of metastatic breast cancer originating from an ovariun primary at MWH for the last 6 yr was 5 of 1,519 breast cancers (0.33%) and 6 of 716 ovarian cancers (0.84%). The ages of these six patients were 35, 56,62,68, 69, and 72 years. The first patient presented with a 3 cm mass involving breast and axillary mass with an elevated serum CA-125 level 1 mo following her stage 1A ovarian cancer diagnosis. The breast FNA diagnosis was metastatic ovarian cancer, which was confirmed by breast biopsy (Fig. C-1). The second patient presented with right breast and axillary masses, a chest wall tumor, cachexia,

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