Abstract
Patient treatment and outcome after breast cancer orbital and periorbital metastases: a comprehensive case series including analysis of lobular versus ductal tumor histology
Breast cancer research : BCR, v 22(1), pp 70-70
26 Jun 2020
PMID: 32586354
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Breast cancer is the most common malignancy to spread to the orbit and periorbit, and the invasive lobular carcinoma (ILC) histologic subtype of breast cancer has been reported to form these ophthalmic metastases (OM) more frequently than invasive ductal carcinomas (IDC). We herein report our single academic institution experience with breast cancer OM with respect to anatomical presentation, histology (lobular vs. ductal), treatment, and survival.
We employed the natural language processing platform, TIES (Text Information Extraction System), to search 2.3 million de-identified patient pathology and radiology records at our institution in order to identify patients with OM secondary to breast cancer. We then compared the resultant cohort, the "OM cohort," to two other representative metastatic breast cancer patient (MBC) databases from our institution. Histological analysis of selected patients was performed.
Our TIES search and manual refinement ultimately identified 28 patients who were diagnosed with breast cancer between 1995 and 2016 that subsequently developed OM. Median age at diagnosis was 54 (range 28-77) years of age. ER, PR, and HER2 status from the 28 patients with OM did not differ from other patients with MBC from our institution. The relative proportion of patients with ILC was significantly higher in the OM cohort (32.1%) than in other MBC patients in our institution (11.3%, p = 0.007). Median time to first OM in the OM cohort was 46.7 months, and OM were the second most frequent first metastases after bony metastases. After diagnosis of the first distant metastasis of any kind, median survival of patients with ILC (21.4 months) was significantly shorter than that of patients with IDC (55.3 months, p = 0.03). Nine patients developed bilateral OM. We observed a significant co-occurrence of OM and central nervous system metastases (p = 0.0053). The histological analysis revealed an interesting case in which the primary tumor was of a mixed ILC/IDC subtype, while only ILC was present in the OM.
OM from breast cancer are illustrative of the difference in metastatic behavior of ILC versus IDC and should be considered when treating patients with ILC, especially in those with complaints of visual acuity changes.
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Details
- Title
- Patient treatment and outcome after breast cancer orbital and periorbital metastases: a comprehensive case series including analysis of lobular versus ductal tumor histology
- Creators
- Martin Blohmer - University of PittsburghLi Zhu - University of PittsburghJennifer M Atkinson - University of PittsburghSushil Beriwal - UPMC Hillman Cancer CenterJoshua L Rodríguez-López - University of Pittsburgh School of MedicineMargaret Rosenzweig - Magee-Womens Research InstituteAdam M Brufsky - UPMC Hillman Cancer CenterGeorge Tseng - Magee-Womens Research InstitutePeter C Lucas - Magee-Womens Research InstituteAdrian V Lee - Magee-Womens Research InstituteSteffi Oesterreich - Magee-Womens Research InstituteRachel C Jankowitz - UPMC Hillman Cancer Center
- Publication Details
- Breast cancer research : BCR, v 22(1), pp 70-70
- Publisher
- Springer BMC
- Grant note
- SAC160073 / Susan G. Komen CCR14300865 / Susan G. Komen U24 CA180921 / NCI NIH HHS P30 CA047904 / NCI NIH HHS SAC150021 / Susan G. Komen
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000545926300001
- Scopus ID
- 2-s2.0-85087139440
- Other Identifier
- 991021897290704721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Oncology