June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Periorbital and Orbital Metastases of Breast Cancer
Author Affiliations & Notes
  • Marissa K. Shoji
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Matthew Camacho
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Yoseph Sayegh
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Emily Mejia
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Vincent Tang
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Carmen Gomez-Fernandez
    Pathology, University of Miami School of Medicine, Miami, Florida, United States
  • Sander Dubovy
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Marissa Shoji None; Matthew Camacho None; Yoseph Sayegh None; Emily Mejia None; Vincent Tang None; Carmen Gomez-Fernandez None; Sander Dubovy None
  • Footnotes
    Support  Supported by the NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, Department of Defense (DOD-Grant#W81XWH-09-1-0675 and Grant#W81XWH-13-10048), and Florida Lions Eye Bank
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 3607. doi:
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    • Get Citation

      Marissa K. Shoji, Matthew Camacho, Yoseph Sayegh, Emily Mejia, Vincent Tang, Carmen Gomez-Fernandez, Sander Dubovy; Periorbital and Orbital Metastases of Breast Cancer. Invest. Ophthalmol. Vis. Sci. 2023;64(8):3607.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Breast cancer is the most common primary source of orbital metastases but is rare overall. This study aims to provide a large institutional retrospective study to assess clinical and radiographic features, histopathologic findings, treatment, and outcomes of patients with orbital metastasis of breast cancer.

Methods : A retrospective review of the Florida Lions Ocular Pathology database at Bascom Palmer Eye Institute from 1997-2022 identified patients with breast cancer metastasis to the orbit and ocular adnexa. Medical records were reviewed for patient demographics, clinical, imaging, and histopathological findings, management, and outcomes.

Results : Thirty-seven patients were identified with clinical details available for 23 (Table 1). The mean age at orbital presentation was 61±13 years. All patients were female (39% Caucasian, 35% black). 19 (82%) patients had a prior diagnosis of breast cancer (mean 4.6 years between primary and orbital diagnosis) while 4 (17%) presented with orbital lesions as first manifestation of systemic disease. 22 patients had unilateral lesions and 1 had bilateral. 43% had an orbital lesion ipsilateral to the prior breast lesion. 19 occurred in the orbit, while 1 occurred in the extraocular muscle (EOM), 2 in the eyelid, and 1 in the conjunctiva. Patients had ptosis (57%), decreased vision (30%), diplopia (35%), proptosis (22%), and enophthalmos (22%). On imaging, 39% were extraconal, 39% were both intra- and extraconal, 35% involved the lacrimal gland, and 52% involved EOM. All patients underwent diagnostic biopsy without further orbital surgery. 76% were invasive lobular and 24% were invasive ductal carcinoma. Of the total cases (n=37), 21 (57%) were ER+/PR+, 12 (32%) were ER+/PR-, only one was HER2+ (ER+/PR-), and 4 cases (11%) were triple negative. Of patients with specified treatment (n=16), the majority received chemotherapy (94%) and orbital radiation (69%). At follow-up (mean 39 months), 13 (57%) were alive with disease, 2 (9%) were alive disease-free, and 4 (17%) were deceased.

Conclusions : This large institutional study highlights clinical and immunohistochemical features of periorbital and orbital metastatic breast carcinoma. It may have variable clinical presentation, represent the first manifestation of systemic disease, and is more often invasive lobular with ER+/PR+ on histopathology. Treatment includes chemotherapy and radiation; however, the overall rate of disease-free survival remains low.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

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