Although metastatic neoplasms in the head and neck are rare compared to primary head and neck neoplasms, metastatic breast carcinoma has been described at numerous sites in the head and neck region. Two cases of breast carcinoma metastatic to sites in the head and neck are reported. In one case a laryngeal metastasis represented the first manifestation of recurrent breast cancer. The second case, a nasal metastasis, was unsuspected and was treated as cellulitis. The presentation of metastatic breast carcinoma to the head and neck may in fact be atypical, posing a diagnostic dilemma. These cases illustrate the importance of past medical history and the high index of suspicion in patients with a history of prior malignancy.