Learning objectives
To acknowledge that breast cancer may rarely underlie ophthalmic presentations.
To recognize the salient imaging features in such cases.
Background
Breast cancer is the most prevalent female malignancy.
In Ireland,
one in every nine women will be diagnosed with breast cancer in her lifetime [1].
Despite recent advances in the diagnosis and treatment of breast cancer,
up to one-third of those diagnosed will go on to develop metastatic disease [2].
Common sites for metastasis include the bone,
lungs,
regional lymph nodes,
liver and brain.
The orbit is a much less frequent site of spread.
Even so,
breast cancer is the most common primary malignancy to...
Findings and procedure details
Case 1
A 42-year old female presented with a left upper eyelid lesion causing unilateral ptosis.
CT and MRI demonstrated an ill-defined extraconal mass in the left orbital roof with no associated bone erosion (Fig.
1).
Excisional biopsy favoured metastatic breast cancer.
Subsequent breast examination found bilateral breast masses and an enlarged left axillary lymph node.
Ultrasound and contrast-enhanced mammography showed bilateral breast masses suspicious for malignancy (Fig.
2).
Breast biopsies diagnosed invasive lobular carcinoma.
Staging CT,
bone scintigraphy and MRI revealed multiple osseous metastases...
Conclusion
Breast cancer is the second most-frequent cause of cancer-related deaths among women [2].
The cases described in this poster illustratethe importance of considering breast cancer when investigating orbital tumours in female patients,particularly given the high incidence of breast cancer and high mortality associated with stage IV disease.
By being familiar with the spectrum of related findings on imaging,
the radiologist may be the first to suggest breast cancer as a possible underlying primary in cases of orbital metastatic disease and can appropriately direct further investigation....
References
1.
https://www.breastcancerireland.com/facts-and-figures/
2.
Georgalas I,
Paraskevopoulos T,
Koutsandrea C,
et al.
Ophthalmic metastasis of breast cancer and ocular side effects from breast cancer treatment and management: Mini review.
BioMed Research International, Vol.
2015,
1-8.
3.
Park YM,
Park JH,
Lee SU,
Lee JS.
Metastatic breast cancer presenting as a subconjunctival mass.
J Breast Cancer 2014;17(1): 88-90.
4.
Rakul Nambiar K,
Ajith PS,
Arjunan A.
Unilateral proptosis as the initial manifestation of malignancy.
J Egypt Natl Canc Inst 2017;29(3):159-161.
5.
Maliepaard M,
Mesham M,
Aleksic Z,...