A Case in Which Surgical Intervention for a Metastatic Ovarian Tumor Helped in Planning a Treatment Strategy for Recurrent Breast Cancer

Abstract

Surgical resection is generally not recommended for patients with distant metastasis of breast cancer. However, we report a case in which bilateral salpingo-oophorectomy for a unilateral ovarian tumor with no preoperative suspicion of malignancy was helpful in the treatment of recurrent breast cancer. The patient was a 49-year-old woman who underwent surgery for invasive ductal carcinoma of left breast at the age of 41 years. Because the tumor was hormone sensitive, the patient was treated with radiotherapy, luteinizing hormone-releasing hormone (LHRH) agonists, and tamoxifen for 5 years after surgery. Approximately 7 years after surgery, she was found to have multiple bone metastases. Therefore, radiation, LHRH agonist, and aromatase inhibitor therapies were initiated. After the initiation of LHRH agonist therapy, a 4-cm right ovarian cyst appeared, which slowly increased in size to 6 cm over 1 year. She visited our department, and magnetic resonance imaging revealed a unilateral polycystic ovarian tumor with some solid components but with no apparent evidence of malignancy. Laparoscopic bilateral salpingo-oophorectomy was performed. The postoperative pathological diagnosis was breast cancer metastasis with estrogen receptor positivity. This surgical intervention not only enabled pathological search and resulted in surgical menopause but also identified biomarkers in the tissue of the removed tumor, which was useful in planning the treatment strategy for recurrent breast cancer.