FREQUENCY OF ASYMPTOMATIC CHOROIDAL METASTASIS IN PATIENTS WITH DISSEMINATED BREAST-CANCER - RESULTS OF A PROSPECTIVE SCREENING-PROGRAM

Aim-To determine the frequency of visually asymptomatic choroidal meta stasis in patients with disseminated breast cancer and its dependence on the incidence of metastasis by number and site of other organ metas tases. Methods-From January 1995 until April 1997 120 patients irradia ted for disseminated breast cancer underwent ophthalmological screenin g for choroidal metastasis. No patient was symptomatic for ocular dise ase. 68 out of 120 patients were found to have metastases in one organ and 52 patients had metastases in more than one organ. 80% of the pat ients had bone metastases, 25% lung metastases, 22% liver metastases, 15% brain metastases, and 22% had metastases in other organs. Results- Six patients (5%) were found to have asymptomatic choroidal metastases . Five patients had unilateral and one patient bilateral metastases. 5 2 patients with more than one involved organ had a significantly highe r risk for asymptomatic choroidal metastasis (6/52, 11%) than 68 patie nts with metastases in only one organ (0/68) (p=0.006). In univariate analysis a significantly higher risk was seen for patients with lung m etastases (14% choroidal metastases versus 2% in patients without lung metastases, p=0.03) and for patients with brain metastases (17% choro idal metastases versus 3% in those without brain metastases, p=0.04). Conclusion-In disseminated breast cancer the incidence of asymptomatic choroidal metastases was 5% and increased to 11% when more than one o rgan was involved in metastatic spread. Risk factors for choroidal met astases were dissemination of disease in more than one organ and the p resence of lung and brain metastases.