Background: Breast cancer (BC) is a frequent malignant dis ease which tends to develop distant metastases, but only very rarely in the head and neck region. Case report: We present two case reports of patients with metastases of invasive BC in this area. They are of different clinical ma nifestation with different time relation to the primary tumor and different symp tomatology. In the case of the first patient, a few years without evidence of malignant dis ease after treatment of primary tumor in complete remission. In the case of the second patient, as the first symp tom of undia gnosed dis ease. Metastases were clinically observed in the skull base and maxillary sinus, manifest ing neurologically with foramen jugulare syndrome and orbital symp toms, resp. In both cases, correlations between histological and clinical findings were essential for dia g nosis. Palliative multimodal treatment was then employed. Conclusion: Metastases of BC in the head and neck region occur only very rarely. The extremely variable symp tomatology de pends on the location of the metastasis and the affected structures. This might be a pitfall for dia gnostics, especially in cases of an unidentified primary breast tumor, which may result in a delay of correct dia gnosis. In addition, the correlation between histopathological and clinical findings might be of great relevance in these cases.