Ovarian metastasis from breast cancer in three Chinese females

Abstract

Rationale:The biological behavior and clinical features of ovarian metastasis from breast cancer remain unclear; diagnosis and treatment of this condition are challenging.Patient concerns:We reported three cases of ovarian metastasis from breast cancer in Chinese women aged 44, 46, and 30 years. The prognosis was different in all three patients; however, no symptoms of ovarian metastasis were observed.Diagnosis:All three premenopausal patients were diagnosed with hormone receptor-positive breast cancer and two of them had axillary lymph node metastasis. All three women had multiple extra-ovarian metastases when ovarian metastasis was detected.Interventions:All patients received systemic antitumor therapy and underwent bilateral ovariectomy.Outcomes:Patient 1 had stable bone metastasis; patient 2 had stable lung metastasis and died of heart disease, and patient 3 had multiple brain metastases, which suggested poor outcomes.Lessons:It is important to screen for ovarian metastasis from breast cancer when evaluating suspicious ovarian masses detected via transvaginal ultrasound in patients with a breast cancer history. Therefore, we recommend simple laparoscopic bilateral oophorectomy not only for pathological diagnosis but also for metastatic tumor removal and therapeutic castration. In such cases, systemic therapy is essential because ovarian metastasis is often a component of systemic metastatic disease.

Metastatic ovarian carcinoma in breast cancer patients during risk-reducing salpingo-oophorectomy: Report of two cases

“…Though, ovarian metastasis is often seen in patients with invasive ductal carcinoma owing to a higher frequency of invasive ductal carcinoma. However, the metastatic tendency of invasive lobular carcinoma to the ovaries is three times greater [ 4 ]. On the contrary, Peters et al found that there are no significant differences in histological subtype between the cases and matched controls among young breast cancer patients [ 1 ].…”

“…The most important step in the management of ovarian metastasis from breast cancer is surgery as it also helps in further diagnosis and staging. For a suspicious ovarian mass in breast cancer patients, a simple laparoscopic oophorectomy can help pathological diagnosis, metastatic tumor removal, and therapeutic castration [ 4 ]. However, high-risk women should be offered prophylactic oophorectomy and the need to possibly undergo a staging procedure if indicated should be well explained to those patients [ 16 ].…”

“…In the majority of cases, the patients are asymptomatic and diagnosis is made incidentally during follow-up breast cancer examination or therapeutic oophorectomy/castration surgery [ 4 ].…”

Hormone Receptor Down-Regulation in Metastatic Breast Cancer After Endocrine Therapy Detected Oophorectomy: A Case Report and Review of Literature

“…However, because of higher rates of IC-NST among all morphological subtypes of breast carcinomas, there are more IC-NSTs encountered in ovarian metastases from breast cancer. Other disease criteria associated with ovarian metastases include ER-positive disease, node-positive disease, inflammatory cancer, large tumour size, and high histological grade [7]. The proliferation index Ki-67 is used as a prognostic and predictive tool in early breast cancer management [8].…”

“…It has been reported that Ki-67 higher than 15% is associated with a higher incidence of metastasis and recurrence; however, this is not specific to ovarian metastasis [9]. Ovarian metastases from primary breast cancer are repeatedly asymptomatic and often diagnosed as an incidental finding during follow-up imaging or after therapeutic oophorectomy; moreover, they commonly manifest as bilateral pathology [7]. Breast cancer metastases to the ovaries seldom occur as an isolated lesion.…”