[Intraocular metastases of metastatic breast carcinoma in the woman. Incidence, risk factors and therapy].

BACKGROUND: The breast cancer metastasis is the most common intraocular tumor in females. Aim of this study was to determine incidence and risk factors for intraocular metastasis and to evaluate the benefit of an early treatment. PATIENTS AND METHODS: 151 patients suffering from metastatic breast cancer were screened for the presence of intraocular metastasis. The medical history and the tumor status at the time of screening were evaluated and risk factors for intraocular metastasis were determined. In case of choroidal metastasis external beam radiotherapy was performed.
RESULTS: Intraocular metastasis was found in 7 out of 151 patients screened (4.6%). In one patient metastasis was located in the iris, in 6 patients in the choroid. Intraocular metastasis was only found in patients with more than one other organ system involved into disease (p = 0.002). In this subgroup of patients (n = 65) prevalence of intraocular metastasis was 10.8%. Other risk factors for intraocular metastasis were presence of lung metastasis or brain metastasis. In 5 out 6 patients with choroidal metastasis external beam radiotherapy was performed, resulting in durable regression of metastasis and stabilization or improvement of visual acuity.
CONCLUSION: The prevalence of intraocular metastasis in metastatic breast cancer was determined to be 4.6%. It is most commonly located in the choroid and develops in the course of advanced metastatic disease. Since early external beam radiotherapy of choroidal metastasis prevents functional loss, patients at risk should be given an ophthalmological screening for intraocular metastasis.