Adnexal masses in women with breast cancer: US findings with clinical and histopathologic correlation

PURPOSE: To correlate ultrasonographic (US), clinical, and histopathologic findings in patients with breast cancer who underwent surgery for adnexal m asses evident at US. MATERIALS AND METHODS: A database search yielded 54 patients with breast ca ncer and with adnexal masses at US and histopathologic examinations. Clinic al, US, and histopathologic findings were correlated. RESULTS: Forty (74%) patients had benign adnexal masses, and 14 (26%) had m alignant masses; three patients had both benign and malignant ovarian masse s. Seven patients had primary ovarian cancer, and seven had breast metastas es to the ovary. All breast metastases to the ovary were bilateral solid ma sses at histopathologic examination and occurred in women with stage IV bre ast carcinoma at the time of US. Eleven ovaries with breast metastases were solid at US. The remaining three ovaries with breast metastases had cystic components at US because of hemorrhage or coexistent benign ovarian cysts. Four of seven patients with primary ovarian carcinoma had bilateral ovaria n tumors, and seven of 11 ovarian carcinomas were predominantly cystic at U S. No patient with primary ovarian carcinoma had stage IV breast cancer. CONCLUSION: In this small series, half the ovarian malignancies in patients with breast cancer were primary ovarian carcinomas and half were breast me tastases to the ovary. Breast metastases to the ovary most frequently are b ilateral solid masses at US and are associated with stage IV disease at the time of US.