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Visual Morbidity and Ocular Disease in Metastatic Breast Carcinoma

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Holistic Approach to Breast Disease

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Abstract

All over the world, breast carcinoma is the most common tumour to affect women. Ocular metastatic foci in breast carcinoma leading to visual morbidity can occur both as a complication of active cancer and as an adverse effect of treatment. Metastases may cause both intra- and extraocular sequelae. Uveal tissue is the predominant site of metastatic disease due to its high vascularity, increased blood flow and architecture of blood vessels. Choroidal metastases are usually detected 3 years after diagnosis of primary breast carcinoma and are rarely the initial manifestation. Metastatic lesions appear as yellow, plateau-shaped, ill-defined masses of 3 mm thickness with subretinal fluid.

Complaints are usually painless blurred vision or may be asymptomatic. The various ophthalmic treatment options for choroidal metastases are external beam radiotherapy, plaque radiotherapy systemic chemotherapy, adjuvant hormone therapy, enucleation and observation. Ocular tumour regression is comparable in those who receive radiotherapy or systemic treatment. In those with ocular metastases, the mean survival time is about 21 months. The ophthalmologist has an important role in the detection of metastatic disease and during follow-up. Prompt management with local and systemic therapy will improve visual prognosis.

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References

  1. Jemal A, Siegel R, Ward E, et al. Cancer statistics. CA Cancer J Clin. 2009;59:225–49.

    Article  PubMed  Google Scholar 

  2. Demirci H, Shields CL, Chao A, Shields JA. Uveal metastasis from breast cancer in 264 patients. Am J Ophthalmol. 2003;136:264–71.

    Article  PubMed  Google Scholar 

  3. Shields CL, Shields JA, Gross NE, Schwartz GP, Lally SE. Survey of 520 eyes with uveal metastases. Ophthalmology. 1997;104:1265–76.

    Article  CAS  PubMed  Google Scholar 

  4. Mejia-Novelo A, Varado-Miranda A, Morales-Vazquez F, et al. Ocular metastases from breast carcinoma. Med Oncol. 2004;21:217–21.

    Article  PubMed  Google Scholar 

  5. Fenton S, Kemp EG, Harnett AN. Screening for ophthalmic involvement in asymptomatic patients with metastatic breast carcinoma. Eye (Lond). 2004;18(1):38–40.

    Article  CAS  PubMed  Google Scholar 

  6. d’Abbadie I, Arriagada R, Spielmann M, Le MG. Choroid metastases: clinical features and treatments in 123 patients. Cancer. 2003;98:1232–8.

    Article  PubMed  Google Scholar 

  7. Mathis T, Jardel P, Loria O, Delaunay B, Nguyen AM, Lanza F, Mosci C, Coujolle JP, Kodjikian L, Thariat J. New concepts in the diagnosis and management of choroidal metastases. Prog Retin Eye Res. 2019;68:144–17.

    Article  PubMed  Google Scholar 

  8. Arepalli S, Kaliki S, Shields CL. Choroidal metastases: origin, features and therapy. Indian J Ophthalmol. 2015;63(2):122–7.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Merrill CF, Kaufman DI, Dimitrov NV. Breast cancer metastatic to the eye is a common entity. Cancer. 1991;68:623–7.

    Article  CAS  PubMed  Google Scholar 

  10. Vishnevskia-Dai V, Zur D, Yaacobi S, Moroz I, Newman H, Neudorfer M. Optical coherence tomography: an adjunctive tool for differentiating between choroidal melanoma and metastasis. J Ophthalmol. 2016;2016:9803547.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Swampillai AJ, Boothe AP, Cohen VM. Ciliary body and iris metastases with anterior chamber angle infiltration L a rare complication from invasive ductal breast cancer. J Glaucoma. 2020;29(3):e12–5.

    Article  PubMed  Google Scholar 

  12. Suhr KS, Sperber LT, Marr P, Kahn JB. Unusual case of iris metastases from breast carcinoma. JCRS Online Case Reports. 2015;3(1):8–11.

    Article  Google Scholar 

  13. Kim CU, Pearce WA. Metastatic breast carcinoma involving the optic disc. Am J Ophthalmol Case Rep. 2020;18:100698.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Fox B, Pacheco P, De Monte F. Carcinoma of the breast metastatic to the optic nerve mimicking an optic nerve sheath meningioma: case report and review of the literature. Skull Base. 2005;15(4):281–7.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Scott BJ, Kesari S. Leptomeningeal metastases in breast cancer. Am J Cancer Res. 2013;3(2):117–26.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Madgula IM, Hemmerdinger CM, Clark P. Metastatic breast cancer presenting as sequential cranial nervepalsy: a case report. J Med Case Rep. 2014;8:430.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Massot-Punyer R, Almajano J, Camacho JM. Cerebral metastasis. Rev Neurol. 2000;31:1242–7.

    Google Scholar 

  18. Ahmad SM, Esmaeli B. Metastatic tumours of the orbit and ocular adnexa. Curr Opin Ophthalmol. 2007;18(5):405–13.

    Article  PubMed  Google Scholar 

  19. Framarino-Dei-Malatesta M, Chiarito A, Bianciardi F, Fiorelli M, Ligato A, Pecorella I. Metastases to extraocular muscles from breast cancer: case report and up-to-date review of the literature. BMC Cancer. 2019;19(1):36.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Fonseca NL, Lucci LMD, Cha SB, Rosetti C, Rehder JRCL. Metastatic eyelid disease associated with primary breast carcinoma: case report. Arq Bras Oftalmol. 2009;72(3):390–3.

    Article  PubMed  Google Scholar 

  21. Martin J, Fung MA, Lin LK. Breast cancer metastasis masquerading as the great masquerader: sebaceous cell carcinoma. Case Rep Oncol. 2017;10(2):485–8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Hojlo MM, Ejma M, Gorczyca WA, Szymaniec S, Witkowsk D, Fortuna W, Miedzybrodzki R, Rogozinska-Szczepka J, Bartnik W. Cancer-associated retinopathy in patients with breast carcinoma. Arch Immunol Ther Exp. 2007;55(4):261–5.

    Article  Google Scholar 

  23. Alwitry A, Gardner I. Tamoxifenmaculopathy. Arch Ophthalmol. 2002;120:140.

    Google Scholar 

  24. Ugurlu S, Karagoz A, Ekin MA. Ocular findings in breast cancer patients using tamoxifen. Cutan Ocul Toxicol. 2015;34(1):16–20.

    Article  CAS  PubMed  Google Scholar 

  25. Zinchuk O, Watanabe M, Hayashi N, et al. A case of tamoxifenkeratopathy. Arch Ophthalmol. 2006;124:1046–8.

    Article  PubMed  Google Scholar 

  26. Manquez ME, Brown MM, Shields CL, Shields JA. Management of choroidal metastases from breast carcinomas using aromatase inhibitors. Curr Opin Ophthalmol. 2006;17(3):251–6.

    Article  PubMed  Google Scholar 

  27. Gianni L, Panzini I, Li S, Gelber RD, Collins J, Holmberg SB, Crivellari D, Castiglione-Gertsch M, Goldhirsch A, Coates AS, Ravaiolo A, International Breast Cancer Study Group (IBCSG). Ocular toxicity during adjuvant chemoendocrine therapy for early breast cancer: results from International Breast Cancer Study Group trials. Cancer. 2006;106(3):505–13.

    Article  CAS  PubMed  Google Scholar 

  28. Shaik R, Tariq K, Sharma S, Tang S-C. Metastatic breast cancer presenting as orbital mass: a case report with literature review. J Glob Oncol. 2018;4:1–4.

    PubMed  Google Scholar 

  29. Amer R, et al. Treatment options in the management of choroidal metastases. Ophthalmologica. 2004;218(6):372–7.

    Article  PubMed  Google Scholar 

  30. Lim JI, Petrovich Z. Radioactive plaque therapy for metastatic choroidal carcinoma. Ophthalmology. 2000;107:1927–31.

    Article  CAS  PubMed  Google Scholar 

  31. Lin CJ, Tsai YY. The effect of intravitreal bevacizumab and transpupillary thermotherapy on choroidal metastases and literature review. Indian J Ophthalmol. 2015;63(1):37–41.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Kaliki S, Shields CL, Dahmash SA, Mashayekhi A, Shields JA. Photodynamic therapy for choroidal metastasis in 8 cases. Ophthalmology. 2012;119(6):1218–22.

    Article  PubMed  Google Scholar 

  33. Chen CJ, McCoy AN, Brahmer J, Handa JT. Emerging treatments for choroidal metastases. Surv Ophthalmol. 2011;56(6):511–21.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India

    Radha Annamalai

  2. Department of Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India

    Bhawna Dev

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  1. Radha Annamalai
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  2. Bhawna Dev
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Correspondence to Radha Annamalai .

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Editors and Affiliations

  1. Department of Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India

    Bhawna Dev

  2. Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India

    Leena Dennis Joseph

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Annamalai, R., Dev, B. (2023). Visual Morbidity and Ocular Disease in Metastatic Breast Carcinoma. In: Dev, B., Joseph, L.D. (eds) Holistic Approach to Breast Disease. Springer, Singapore. https://doi.org/10.1007/978-981-99-0035-0_34

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  • DOI: https://doi.org/10.1007/978-981-99-0035-0_34

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-0034-3

  • Online ISBN: 978-981-99-0035-0

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