Ocular metastases from breast carcinoma: A multicentric retrospective study

Breast cancer may affect the eye and orbit by metastatic neoplastic infiltr ation, uvea being the most common site of presentation. Management of these cases with radiotherapy is usually gratifying with reported response rate of approximately 75%. A retrospective evaluation of cases treated in five I nstitutions participating in a collaborative radiation therapy group of Nor th-Italy is reported. Fifty-four cases of metastases to the eye or orbit we re referred for radiation therapy to the Departments participating in the s urvey in the period 1977-1995. There were 49 female patients aged between 2 8 and 75 years (median, 44 yeats) at presentation of orbital metastasis. Th irty-eight lesions (70%) were metastases to the choroid, 9 involved other p arts of the eye, and 7 patients had orbital metastases. Five of the 49 pati ents had bilateral choroidal metastases. Radiotherapy was employed with meg avoltage equipment. The median total dose delivered was 40 Gy (range, 16-60 Gy). All the patients were treated 5 times per week with fraction sizes ra nging from 1.8 to 3.0 Gy (median, 2.0 Gy). Of the 43 evaluable eyes, 34 (79 %) showed a definite improvement after radiotherapy. There was a stabilizat ion of the process in 4 patients. The rest (11 lesions) were lost to detail ed follow-up of the response of the eye metastases. Twelve patients experie nced acute transient cherato-conjunctivitis and in a case a subconjunctival haemorrhage was observed; as late side effects, two cases of chataract wer e observed during a period of observation of 37 and 117 months. A median su rvival time of 17 months was observed. The goal of irradiation was to impro ve vision or at least prevent blindness and enucleation. The palliative eff ect of irradiation was confirmed with a response rate consistent with the d ata of the literature on this subject.