Metastatic ovarian carcinoma in breast cancer patients during risk-reducing salpingo-oophorectomy: Report of two cases.

Introduction And Importance: Metastatic ovarian cancer of breast carcinoma is rare and accounts for only 0.68%-2% of all ovarian tumors, the majority of which are diagnosed incidentally during follow-up or therapeutic oophorectomy. Risk-reducing salpingo-oophorectomy (RRSO) is a highly recommended prophylactic surgery associated with a significant decrease in ovarian cancer risk in both and mutation carriers, and in those with and without prior breast cancer.

Case Presentation: We present two cases who presented with a lump in the right axilla and left breast respectively and were subsequently diagnosed as invasive mammary carcinoma but later, diagnosed with metastatic ovarian carcinoma with breast primary after RRSO. The patients were treated with cycles of chemo-radiation.

Discussion: Invasive lobular carcinoma, larger tumor size, advanced breast cancer increases the risk of developing ovarian metastases. Thorough macroscopic, microscopic, immunohistochemical, and molecular tests are considered the cornerstone in the diagnosis of metastatic breast cancer to the ovaries. Bilateral salpingo-oophorectomy, a risk-reducing surgery for the BRCA gene mutation, has been shown to reduce the risk of death from ovarian cancer.

Conclusions: Metastatic ovarian cancer in breast cancer is a rare possibility among patients undergoing RRSO for breast cancer. The importance of continued surveillance of ovaries rather than the delayed diagnosis of ovarian metastasis for patients with newly diagnosed breast cancer cannot be less emphasized.