Celine Pimentel1, Margaux Becquet2, Vincent Lavoue3, Sebastien Henno4, Jean Leveque5, Lobna Ouldamer2. 1. Department of Gynecology, Obstetrics and Human Reproduction, University Hospital, Rennes, France. 2. Department of Gynecology, Obstetrics and Reproductive Medicine, University Hospital, Tours, France. 3. Department of Gynecology, Obstetrics and Human Reproduction, University Hospital, Rennes, France Comprehensive Cancer Center Eugene Marquis, Rennes, France. 4. Department of Pathology, University Hospital, Rennes, France. 5. Department of Gynecology, Obstetrics and Human Reproduction, University Hospital, Rennes, France Comprehensive Cancer Center Eugene Marquis, Rennes, France jean.leveque@chu-rennes.fr.
Abstract
BACKGROUND/AIM: Ovarian metastases from breast cancer present diagnostic and therapeutic challenges. We conducted a two-center retrospective study to analyze the characteristics and evolution of patients with histologically proven ovarian metastases from breast cancer. PATIENTS AND METHODS: The records of 28 patients were analyzed, taking into consideration clinical and biological characteristics of primary breast tumors and ovarian metastases. Moreover, the outcomes of patients after diagnosis of metastases were analyzed by comparing two patient groups defined by whether the surgical treatment of ovarian metastases was optimal (residual tumor <2 cm) or not (residual tumor >2 cm). RESULTS: Ovarian metastases are largely found in primary breast cancer patients with poor prognostic factors (large tumor size, positive lymph nodes, high-grade) and lobular histology, occurring on average 5 years after the diagnosis of breast cancer. Their symptoms are mild and measurement of serum markers cancer antigen (CA) 125 and CA 15-3 is useful. Their prognosis is bleak due to frequent co-existence with other metastatic sites. Lobular histology of the initial breast tumor is the only significant poor prognostic factor in our study. CONCLUSION: Women with lobular carcinoma of the breast and poor prognostic factors may benefit from ovarian surveillance based on CA 125. Following the discovery of ovarian metastases from breast cancer, further investigations are warranted to determine the extent of disease, specifically whether multiple metastases are present. Treatment of a solitary ovarian metastasis is based on surgery leaving no residual disease and adjuvant systemic treatment. Copyright
BACKGROUND/AIM: Ovarian metastases from breast cancer present diagnostic and therapeutic challenges. We conducted a two-center retrospective study to analyze the characteristics and evolution of patients with histologically proven ovarian metastases from breast cancer. PATIENTS AND METHODS: The records of 28 patients were analyzed, taking into consideration clinical and biological characteristics of primary breast tumors and ovarian metastases. Moreover, the outcomes of patients after diagnosis of metastases were analyzed by comparing two patient groups defined by whether the surgical treatment of ovarian metastases was optimal (residual tumor <2 cm) or not (residual tumor >2 cm). RESULTS:Ovarian metastases are largely found in primary breast cancerpatients with poor prognostic factors (large tumor size, positive lymph nodes, high-grade) and lobular histology, occurring on average 5 years after the diagnosis of breast cancer. Their symptoms are mild and measurement of serum markers cancer antigen (CA) 125 and CA 15-3 is useful. Their prognosis is bleak due to frequent co-existence with other metastatic sites. Lobular histology of the initial breast tumor is the only significant poor prognostic factor in our study. CONCLUSION:Women with lobular carcinoma of the breast and poor prognostic factors may benefit from ovarian surveillance based on CA 125. Following the discovery of ovarian metastases from breast cancer, further investigations are warranted to determine the extent of disease, specifically whether multiple metastases are present. Treatment of a solitary ovarian metastasis is based on surgery leaving no residual disease and adjuvant systemic treatment. Copyright
Authors: Saraswoti Khadge; Geoffrey M Thiele; John Graham Sharp; Timothy R McGuire; Lynell W Klassen; Paul N Black; Concetta C DiRusso; Leah Cook; James E Talmadge Journal: Clin Exp Metastasis Date: 2018-10-16 Impact factor: 5.150