Medline ® Abstract for Reference 63
of 'The role of local therapies in metastatic breast cancer'
Ovarian disease in women with breast cancer.
Curtin JP, Barakat RR, Hoskins WJ
Obstet Gynecol. 1994;84(3):449.
OBJECTIVE: To correlate ovarian pathology findings with the indications for surgery, age, initial breast cancer stage, prior therapy for breast cancer, and current status of disease.
METHODS: We reviewed the charts of women with breast cancer who underwent oophorectomy at a single institution during the period 1987-1993. Two hundred thirty women were identified. The indications for oophorectomy were divided into three groups: 1) incidental, with no ovarian symptoms; 2) therapeutic oophorectomy for treatment of metastatic breast cancer; and 3) patients with adnexal or pelvic mass. Ovarian pathology was classified as benign, metastasis from breast primary, or primary ovarian or tubal malignancy.
RESULTS: Eighty-nine women underwent oophorectomy incidental to pelvic surgery; one patient had metastatic breast cancer present in the ovaries and three patients had a clinically unsuspected ovarian or tubal primary cancer. Twenty patients had bilateral oophorectomy as therapy for metastatic breast cancer, and five of 20 (25%) had metastatic breast cancer to the ovaries. One hundred twenty-one women with a preoperative diagnosis of adnexal or pelvic mass underwent oophorectomy (unilateral or bilateral). Sixty-one (50%) had a benign process. Sixty patients were found to have a malignant neoplasm, including 44 new ovarian or tubal primary cancers and 16 with metastatic mammary cancer.
CONCLUSIONS: Patients who present with new findings of an adnexal or pelvic mass are more likely to have a new ovarian or tubal malignancy than metastatic breast cancer, by a ratio of 3:1. These patients require complete evaluation; one should not assume that the adnexal or pelvic mass represents metastatic disease from the breast primary cancer.
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.