Intraocular metastasis in metastatic female breast cancer. Incidence, riskfactors and therapy

Background: The breast cancer metastasis is the most common intraocular tum or in females. Aim of this study was to determine incidence and risk factor s for intraocular metastasis and to evaluate the benefit of an early treatm ent. Patients and Methods: 151 patients suffering from metastastic breast cancer were screened for the presence of intraocular metastasis. The medical hist ory and the tumor status at the time of screening were evaluated and risk f actors for intraocular metastasis were determined. In case of choroidal met astasis external beam radiotherapy was performed. Results: Intraocular metastasis was found in 7 out of 151 patients screened (4.6%). In one patient metastasis was located in the iris,in 6 patients in the choroid. Intraocular metastasis was only found in patients with more t han one other organ system involved into disease (p=0.002). In this subgrou p of patients (n=65) prevalence of intraocular metastasis was 10,8%. Other risk factors for intraocular metastasis were presence of lung metastasis or brain metastasis. In 5 out 6 patients with choroidal metastasis external b eam radiotherapy was performed, resulting in durable regression of metastas is and stabilization or improvement of visual acuity. Conclusion: The prevalence of intraocular metastasis in metastatic breast c ancer was determined to be 4.6%. It is most commonly located in the choroid and develops in the course of advanced metastastic disease. Since early ex ternal beam radiotherapy of choroidal metastasis prevents functional loss, patients at risk should be given an ophthalmological screening for intraocu lar metastasis.