Ovarian metastasis from breast cancer in three Chinese females: Three case reports

Artificial Ovary for Young Female Breast Cancer Patients

In recent decades, there has been increasing attention toward the quality of life of breast cancer (BC) survivors. Meeting the growing expectations of fertility preservation and the generation of biological offspring remains a great challenge for these patients. Conventional strategies for fertility preservation such as oocyte and embryo cryopreservation are not suitable for prepubertal cancer patients or in patients who need immediate cancer therapy. Ovarian tissue cryopreservation (OTC) before anticancer therapy and autotransplantation is an alternative option for these specific indications but has a risk of retransplantation malignant cells. An emerging strategy to resolve these issues is by constructing an artificial ovary combined with stem cells, which can support follicle proliferation and ensure sex hormone secretion. This promising technique can meet both demands of improving the quality of life and meanwhile fulfilling their expectation of biological offspring without the risk of cancer recurrence.

Metastatic ovarian carcinoma in breast cancer patients during risk-reducing salpingo-oophorectomy: Report of two cases

INTRODUCTION AND IMPORTANCE

Metastatic ovarian cancer of breast carcinoma is rare and accounts for only 0.68%-2% of all ovarian tumors, the majority of which are diagnosed incidentally during follow-up or therapeutic oophorectomy. Risk-reducing salpingo-oophorectomy (RRSO) is a highly recommended prophylactic surgery associated with a significant decrease in ovarian cancer risk in both BRCA1 and BRCA2 mutation carriers, and in those with and without prior breast cancer.

CASE PRESENTATION

We present two cases who presented with a lump in the right axilla and left breast respectively and were subsequently diagnosed as invasive mammary carcinoma but later, diagnosed with metastatic ovarian carcinoma with breast primary after RRSO. The patients were treated with cycles of chemo-radiation.

DISCUSSION

Invasive lobular carcinoma, larger tumor size, advanced breast cancer increases the risk of developing ovarian metastases. Thorough macroscopic, microscopic, immunohistochemical, and molecular tests are considered the cornerstone in the diagnosis of metastatic breast cancer to the ovaries. Bilateral salpingo-oophorectomy, a risk-reducing surgery for the BRCA gene mutation, has been shown to reduce the risk of death from ovarian cancer.

CONCLUSIONS

Metastatic ovarian cancer in breast cancer is a rare possibility among patients undergoing RRSO for breast cancer. The importance of continued surveillance of ovaries rather than the delayed diagnosis of ovarian metastasis for patients with newly diagnosed breast cancer cannot be less emphasized.

Hormone Receptor Down-Regulation in Metastatic Breast Cancer After Endocrine Therapy Detected Oophorectomy: A Case Report and Review of Literature

Globally, breast cancer is the most frequently diagnosed malignancy among women; it is also one of the leading causes of cancer mortality among females. The most common sites for metastases are the lungs, bones, liver, and brain. Breast cancer is recognized as one of the most common primary sites of metastatic lesions in the ovaries and is often associated with multiple extra-ovarian metastases. Here, we report a case of occult breast cancer metastases to the ovaries with a down-regulated hormonal immunohistochemistry profile after endocrine therapy, encountered incidentally after oophorectomy.