Choroidal metastases from breast cancer – clinical observations of 18 cases

Purpose
To present clinical picture and results of treatment of breast carcinoma metastases to choroid.

Material and methods
Eighteen females (26 eyes), age: 31-70 years old; mean age: 50.5 ±14.5 years with breast carcinoma choroidal metastases were enrolled in this study. Choroidal metastases occurred 1 month to 288 months, mean: 64 ±33 months, after primary tumors had been diagnosed. In all cases basic eye examination with ultrasonography as well as fluorescein and indocyanine green angiography in some patients, were performed. Method of treatment was applied according to tumor size and its localization; 106Ru plaque therapy was used in 8 cases, 125I in 2, transpupillary therapy (TTT) in 8, 106Ru + TTT (“sandwich method”) in 4, teleradiotherapy in 3 and enucleation was performed in one case. The follow-up period ranged from 6 months to 5 years, mean 15.3 ±7.7 months.

Results
Unilateral choroidal metastases were present in 10 patients and bilateral in 8. Single metastatic lesions were detected in 15 patients and multiple in 3. Tumors thickness measured by ultrasonography ranged from 1.2 to 16.2 mm. After therapy regression of tumors was noted in 7 eyes (10 tumors), among which in four eyes (7 tumors) total regression was observed. Stabilization was found in 4 eyes (4 tumors) and progression in other 4 eyes (4 lesions).

Conclusions
Tumor size, its localization and general patient condition are the main factors deciding about the method in treatment of choroidal metastases. Plaque therapy and transpupillary thermotherapy are effective methods of treatment in majority of metastatic tumors. They induce tumor regression and in some cases they may provide improvement in visual acuity.