Prevalence and Risk Factors of Ovarian Metastases in Breast Cancer Patients < 41 Years of Age in the Netherlands: A Nationwide Retrospective Cohort Study

Abstract

PurposeBreast cancer is one of the primary indications for cryopreservation and subsequent autotransplantation of ovarian tissue. The safety of this fertility preservation method remains questionable, as the presence of disseminated breast tumor cells cannot yet be excluded in the ovarian autografts. We explored the prevalence of ovarian metastases among young breast cancer patients and determined risk factors for the development of ovarian metastases.MethodsUsing the nationwide database of the Dutch Pathology Registry (PALGA), we identified a cohort of 2648 women with primary invasive breast cancer at age < 41 years in the period 2000–2010 in the Netherlands who subsequently underwent an oophorectomy. From this source population, all cases who had histologically confirmed ovarian metastases were included. For each case of whom clinical data were available, one control without ovarian metastases who matched the time interval between breast cancer diagnosis and oophorectomy was selected. Data were collected on patient characteristics, diagnosis, treatment and follow-up.ResultsOvarian metastases were found in 63 out of 2648 patients who met the inclusion criteria. The risk of developing ovarian metastases increased with time passed since breast cancer diagnosis. Multivariate logistic regression analyses showed significant association between tumor stage and the development of ovarian metastases (p = 0.024).ConclusionsThe prevalence of ovarian metastases was 2.4% among young breast cancer patients. Early ovary removal may reduce the risk of developing ovarian metastases. In breast cancer patients with tumors > 5 cm and/or inflammatory carcinoma, we recommend a cautious approach to ovarian tissue autotransplantation.

The evaluation of laparotomy results in breast cancer patients with gynecological pathologies

“…stated that lobular BCs are more likely to metastasize to the ovary than ductal BCs; however, Peters et al . did not observe any significant differences in histological subtypes of BCs that metastasize to the ovaries 6,24 . In our study, 6 women had breast carcinoma metastases to ovary and the subtype was lobular carcinoma in 3 of them.…”

“…Adnexal masses are frequently seen in BC patients. Ovarian involvement is the most common one in female genital tract metastases, the incidence of ovarian metastases in BC patients is 13–47%, which was demonstrated by the methods of autopsies as well as prophylactic and therapeutic oophorectomies 4–6 …”

Ovarian metastasis from breast cancer mimicking a primary ovarian neoplasm: A case report

“…However, it has been reported that the primary tumor could not be identified in 15% of OM cases (17). The incidence of OM in patients with breast cancer ranges between 13 and 47% (these percentages are mainly based on autopsies or prophylactic or therapeutic oophorectomies) (18)(19)(20). OM from breast cancer is mainly found after surgery at the primary site.…”

Ovarian metastasis from breast cancer in three Chinese females

“…Many studies suggest that up to 50% of ovarian metastases are bilateral. [5,6,15,16] Moreover, MRI has high accuracy for differentiating benign and malignant ovarian tumors. [17] Regarding serum markers, patients with metastases showed lower levels of serum CA125 (<80 U/mL), higher levels of serum CA153 (>100 U/mL), and lower BRCA mutation probability (<20%) than patients with primary ovarian tumors.…”