Prophylactic Irradiation for Asymptomatic Orbital Metastasis in Invasive Ductal Carcinoma of the Breast—A Case Report—

Abstract

As advanced orbital metastasis of malignant tumors can lead to blindness and significantly impair the quality of life of patients, early therapeutic intervention is necessary.

A 66-year-old woman underwent partial mastectomy and sentinel lymph node biopsy for left-sided breast cancer. Twelve years later, axillary lymph node recurrence was observed. Axillary dissection (up to level II) was performed, and chemotherapy and endocrine therapy were continued. However, four years later, the patient developed severe nausea and vomiting, and contrast-enhanced magnetic resonance imaging (MRI) of the head revealed multiple brain and skull metastases. Additionally, multiple enlarged extraocular muscles and internal nodular lesions were observed, strongly suggesting orbital metastasis of the cancer. To prevent the development of ocular symptoms, whole-brain irradiation (30 Gy in 10 fractions), including the sites of orbital metastases, was performed. No ocular symptoms were observed until the patient died of the cancer two months later.

Even for asymptomatic orbital metastases, early initiation of radiotherapy is expected to reduce the development of ocular symptoms and maintain the quality of life.