Women with advanced breast cancer frequently have ovarian involvement. The metastases tend to be clinically silent and rarely produce symptoms directly. Rarely, the ovarian metastases manifest before the diagnosis of primary breast cancer. Ovarian involvement may occur decades after the removal of the primary tumor. One should keep in mind that patients with breast cancer are also at increased risk of developing primary ovarian carcinomas especially if they carry BRCA1 and BRCA2 mutations. The image shows solid sheets of tumor cells just beneath the ovarian surface. The variety of histologic patterns seen with the primary breast cancers may be recapitulated in the metastases.