Ovarian metastases from breast cancer: report of 29 cases

The objective of this study was to describe the characteristics and survival outcomes of patients with breast cancer who had ovarian metastases.

Data from 29 women who underwent surgery were reviewed retrospectively (from 1998 to 2007). Patient characteristics, tumor characteristics, and treatment data were collected. Pelvic extent of disease was documented using a system analogous to the International Federation of Gynecology and Obstetrics classification for ovarian cancer. Global survival, disease-free intervals, and the distribution to other metastatic sites over time were studied. Outcomes were compared between the group who underwent macroscopic resection of lesions and the group who did not undergo resection.

The data indicated a predominance of premenopausal and hormone receptor-positive status and a greater prevalence of lobular infiltrating carcinoma, bilateral breast cancer, and predisposing genetic factors compared with the global population with breast cancer. Ovarian disease was diagnosed at a median of 5 years after breast cancer. Seventy-five percent of patients were asymptomatic, and advanced-stage pelvic extent or extra-abdominal metastases were observed in 41.5% of patients. The median survival was 3 years, and the median follow-up was 2 years. Survival improved significantly when optimal debulking surgery was performed.

Breast cancers may be associated with ovarian metastases. The current results indicated that surgical resection tends to increase survival, which may be long; however, larger series would be needed to confirm other prognostic factors. The high rates of hormone receptor-positive tumors and premenopausal patients led the authors to suggest that the surgical option should consist of at least bilateral oophorectomy, even when the contralateral ovary appears to be normal.