Ovarian metastases of breast carcinoma. A clinicopathologic study of 59 cases

Of 165 ovarian metastases recorded in the files of L'Hôtel-Dieu de Québec, Canada, between 1951 and 1987, 64 (38%) were from breast adenocarcinomas. Histopathologic material was available in 59 instances, of which 22 were autopsy cases and 28 were incidental findings at therapeutic oophorectomy. The patients' ages ranged from 25 to 80 years (average, 48.6 years). Sixty-four percent of the metastases were bilateral and 36% were unilateral. An ovarian metastasis was detected before the breast cancer in only one instance. The median interval between the diagnosis of breast carcinoma and the ovarian metastasis was 11.5 months and was related to the initial stage of the breast disease. The median survival after the diagnosis of ovarian metastasis was 16 months. The ovaries were grossly normal in 27 (46%) cases and 18 (31%) metastases were less than 1 mm in diameter. The size of the metastases was not related to the interval after the diagnosis of the breast carcinoma and did not influence the outcome of the patients. Forty-four metastases (75%) showed an indian file or ductal patterns easily identifiable as metastases of breast origin. The remaining cases presented various histologic features mimicking primary ovarian tumors or tumor-like conditions such as stromal luteoma, hyperthecosis, dysgerminoma, granulosa cell tumor, and carcinoid tumor. No metastasis had features of Krukenberg tumor. The authors conclude that metastases from breast cancer are generally small and are the reflection of an advanced disease. A metastasis of breast origin can be suspected histologically in most cases.