A 65-year-old woman with a history of breast cancer 2 years ago presents with bone loss in the upper left quadrant. Radiograph shows a soap-bubble radiolucent lesion between teeth #2 and #3. What is the most likely diagnosis?

Correct answer: D. Bone metastasis from breast cancer

• A. OKC (KCOT) is associated with Gorlin syndrome and presents as a radiolucent lesion, often in the posterior mandible. It is not the most likely diagnosis given the breast cancer history.
• B. Traumatic bone cyst is a pseudocyst seen in young patients after trauma, typically in the posterior mandible. It would not be the primary diagnosis in a cancer patient.
• C. Ameloblastoma most commonly presents in the posterior mandible, not the posterior maxilla between premolars. While it can appear as a soap-bubble lesion, the breast cancer history makes this less likely.
• D. Breast cancer is one of the most common cancers to metastasize to the jaw bones. A 65-year-old woman with known breast cancer presenting with a soap-bubble posterior maxillary radiolucent lesion should be presumed to have bone metastasis until proven otherwise. ✓