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  • Title: Ovarian disease in women with breast cancer.
    Author: Curtin JP, Barakat RR, Hoskins WJ.
    Journal: Obstet Gynecol; 1994 Sep; 84(3):449-52. PubMed ID: 8058246.
    Abstract:
    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.
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