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Breast cancer is the most common cancer in females worldwide and also in Indonesia. Symptomatic bone marrow metastasis is an uncommon presentation of metastatic breast cancer patient. A retrospective study showed that, out of 12970 patients with breast cancer, only 0.17% had symptomatic bone marrow metastasis. Management of patients with bone marrow metastasis also creates dilemma for the clinician. Risk and benefit from treatment should be discussed and carefully considered. We describe here a case report of a 58-year-old female patient with pancytopenia, who had a history of breast cancer four years before. A PET CT Scan showed multiple vertebrae bone metastasis. Bone marrow biopsy revealed marrow infiltration of metastasis breast cancer in bone marrow. This patient received hormonal treatment, which resulted in promising results for four months. Unfortunately, the patient did not come for control regularly and died due to hepatic failure caused by liver metastasis.