Acute liver failure is most commonly caused by either viral infections or drug toxicity. The liver is a common site of metastatic spread of cancer. Nevertheless, metastatic carcinoma of the breast is a rare cause of acute hepatic failure and only 0.44% of cases with fulminant liver failure are manifestations of malignancy, mostly hematological. There are very few reports of acute liver failure due to breast cancer and the prognosis in these cases is bad. This is a case history of a young patient with acute hepatic failure as a presenting symptom for metastatic breast carcinoma, which deteriorated rapidly to a fatal outcome. This case is unique, since only one of 7 cases published so far has no prior breast malignancy history and thus should accentuate the sometimes evasive, yet often fatal nature of advanced breast cancer in women.