Patients with a history of epithelial ovarian cancer presenting with a breast and/or axillary mass Journal Article
| Authors: | Karam, A. K.; Stempel, M.; Barakat, R. R.; Morrow, M.; Gemignani, M. L. |
| Article Title: | Patients with a history of epithelial ovarian cancer presenting with a breast and/or axillary mass |
| Abstract: | Objective: A breast and/or axillary mass in a patient with epithelial ovarian cancer (EOC) may be due to an EOC breast metastasis or a second primary breast cancer. We sought to review our experience with patients with a history of EOC presenting with a breast and/or axillary mass to determine if clinical features differed between these entities. Methods: Between 1/90 and 10/07, 29 women with epithelial EOC presented with a breast or axillary mass, including 10 patients with EOC metastatic to the breast and/or axilla and 19 patients with a second primary breast cancer following their original EOC diagnosis. Clinicopathologic factors/survival were retrospectively abstracted from medical records. Results: The mean EOC disease-free survival (DFS) was 14.9 mo versus 77.4 mo (P < 0.001) for patients with recurrent epithelial ovarian cancer metastatic to the breast and/or axilla and patients with a second primary breast cancer, respectively. Similarly, the mean interval between diagnosis of EOC and the breast and/or axillary event was 31.2 mo versus 70.7 mo for those patients who had metastatic recurrent EOC and those patients with breast cancer (P = 0.02). Patients with a second primary breast cancer were more likely to be diagnosed on mammogram and have a family history of breast and ovarian carcinoma than patients with metastatic EOC to the breast and/or axilla (14/19 [73.7%] versus 2/9 [22.8%], P = 0.02; and 12/18 [66.7%] versus 2/10 [20%], P = 0.05, respectively). Median overall survival for patients with EOC metastasis was 26 mo but was not yet reached for those patients with a second primary breast cancer. On univariate analysis, an ovarian cancer DFS of 12 mo or more and the performance of breast/axillary surgery were associated with a significantly longer overall survival (P = 0.01 and 0.02, respectively), whereas an elevated CA125 level at the time of the breast/axilla event and the presence of EOC metastases to the breast and axilla were significant negative predictors of survival (P = 0.01 and 0.05, respectively). Conclusion: The interval between EOC diagnosis and the breast and/or axilla event, an elevated CA125 level, and a family history of breast and/or ovarian cancer may help differentiate patients with metastatic EOC to the breast and/or axilla from those patients with a second primary breast cancer. The presence of a metastatic EOC portends a poor prognosis. © 2008 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer survival; clinical article; controlled study; aged; disease-free survival; middle aged; survival rate; retrospective studies; overall survival; clinical feature; pathogenesis; cancer recurrence; disease free survival; lymphatic metastasis; ovarian cancer; ovarian neoplasms; ovary cancer; neoplasm recurrence, local; breast cancer; diagnosis, differential; differential diagnosis; breast neoplasms; medical record review; mammography; family history; breast tumor; experience; epithelial cells; high risk population; neoplasms, second primary; ca 125 antigen; epithelium; epithelial ovarian cancer; axillary mass; breast axillary mass |
| Journal Title: | Gynecologic Oncology |
| Volume: | 112 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2009-03-01 |
| Start Page: | 490 |
| End Page: | 495 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2008.11.006 |
| PUBMED: | 19101713 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "CODEN: GYNOA" - "Source: Scopus" |
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