Follow-up case of Left breast Carcinoma operated in 2001, had received adjuvant chemoradiotherapy and was on maintenance oral Tamoxifen drug therapy, developed breathlessness after 19 years. Chest X ray showed left side massive effusion. A chest drain was inserted in emergency, pleural fluid was sampled for malignancy and infection, but came out to be negative ( 3 cellblock reports). PET CECT showed pleural uptake. Diagnostic Video Assisted Thoracoscopy was performed and pleural biopsy was taken. Pleural biopsy came out to be metastasis from primary breast. Bedside pleurodesis with Bleomycin was done, and effusion part was sorted out. Medical oncologist started specific drug therapy. PET CECT after 3 months all lesions disappeared. Patient is doing well and having normal life although the treatment and follow-ups are continued. Even in Stage 4 or recurrence there is hope, new age chemotherapeutics are better tolerated and have a good survival benefit.
