Orbital metastases from breast cancer: A single institution case series

• Published in: Journal of surgical oncology 2020-08, Vol.122 (2), p.170-175
• Main Authors: Sindoni, Alessandro, Fama', Fausto, Vinciguerra, Paolo, Dionigi, Gianlorenzo, Manara, Sofia Ada Assunta Maria, Gaeta, Roberto, Gioffre'‐Florio, Maria, Di Maria, Alessandra
• Format: Article
• Language: English
• Subjects: Breast cancer; breast carcinoma; Cancer therapies; ductal infiltrating breast carcinoma; lobular infiltrating breast carcinoma; Medical diagnosis; Medical prognosis; Metastasis; orbital metastasis
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.25927

Background and Objectives Among orbital tumors, metastatic lesions have a prevalence of 1% to 13%; on the other hand, breast cancer is the most common malignancy causing orbital metastases. The aim of this study is to present our experience dealing with orbital metastases caused by breast cancer, to assess characteristics and clinic‐pathological data of patients suffering from this rare occurrence and to find indexes related with their prognosis and survival. Methods Records of 28 patients diagnosed with orbital metastases from breast cancer at the Department of Ophthalmology, Humanitas Clinical and Research Centre of Milano over a 27‐year period (1992‐2018) were retrieved and analyzed. Results Mean patients' age at breast cancer diagnosis was 56.29 ± 14.63 years. Mean time interval between breast cancer diagnosis and orbital metastasis occurrence was 5 ± 4.17 years. All lesions were estrogen receptor‐positive; 79% of patients harbored progesterone receptor‐positive lesions. Interestingly, the majority of deceased patients presented orbital lesions with MIB‐1 index >50% (P = .0265) and had concomitant lung metastases (P = .0452). Conclusions The occurrence of orbital metastasis from breast cancer represents a challenging finding. Patients' clinical picture can include exophthalmos, edema, tumefaction, proptosis and/or diplopia. Significant symptomatic improvement can be achieved through surgery and other adjuvant treatments, such as radiation therapy and chemotherapy.