Background: Breast cancer remains a leading cause of cancer-related mortality and morbidity worldwide. Ocular and periocular metastasis present as a rare but clinically significant manifestation. This study aims to explore demographics and clinical aspects of ocular and periocular metastasis in breast cancer patients. Methods: A retrospective cohort study comprising 45 breast cancer patients with ocular or periocular metastasis treated between 2013 and 2023. Patient demographics, tumor characteristics, diagnostic methods, treatment modalities, visual outcomes, and survival data were analyzed. Results: Among 9902 breast cancer patients, 0.5% developed ocular or periocular metastasis, constituting 2.4% of metastatic cases. The median age was 50 years. Ocular metastasis timing varied: 5% before breast cancer, 24% concurrent, 22% within a year, and 49% after. The most common presentations included incidental MRI findings (42%) and vision decline (31%). Metastasis involved the orbit (47%), choroid (40%), optic nerve (11%), and iris (2%), with 44% having bilateral involvement. Predictive factors included invasive lobular carcinoma (ILC) (p< 0.0001) and brain metastasis (p< 0.0001), with ILC exhibiting a sixfold higher likelihood of ocular metastasis than invasive ductal carcinoma (IDC). Primary treatment was radiation therapy (89%), yielding a 55% maintenance of excellent vision (<0.5), with 93% developing dry eye disease. Patients with ocular metastasis faced an increased risk of disease-related mortality (p< 0.0001), with 71% succumbing within 10 months post-diagnosis. Conclusions: Ocular metastasis in breast cancer is rare (0.5%) but signifies poor outcome. It is linked to ILC and concurrent brain metastasis. Primary treatment involves radiation therapy, with a favorable visual prognosis.
背景：乳腺癌仍是全球癌症相关死亡和发病的主要原因。眼部及眼周转移是一种罕见但具有重要临床意义的表现。本研究旨在探讨乳腺癌患者眼部及眼周转移的人口统计学和临床特征。 方法：本研究为一项回顾性队列研究，纳入了2013年至2023年间接受治疗的45例伴有眼部或眼周转移的乳腺癌患者。分析了患者人口统计学特征、肿瘤特征、诊断方法、治疗方式、视力结局及生存数据。 结果：在9902例乳腺癌患者中，0.5%发生眼部或眼周转移，占所有转移病例的2.4%。患者中位年龄为50岁。眼部转移发生时间各异：5%在乳腺癌确诊前，24%同时发生，22%在一年内发生，49%在之后发生。最常见的临床表现包括MRI偶然发现（42%）和视力下降（31%）。转移部位涉及眼眶（47%）、脉络膜（40%）、视神经（11%）和虹膜（2%），其中44%为双侧受累。预测因素包括浸润性小叶癌（ILC）（p<0.0001）和脑转移（p<0.0001），ILC发生眼部转移的可能性是浸润性导管癌（IDC）的六倍。主要治疗方式为放射治疗（89%），55%的患者维持了良好视力（<0.5），但93%的患者出现了干眼症。伴有眼部转移的患者疾病相关死亡风险增加（p<0.0001），71%的患者在诊断后10个月内死亡。 结论：乳腺癌眼部转移罕见（0.5%），但提示预后不良。其与ILC和并发脑转移相关。主要治疗为放射治疗，视力预后良好。
肿瘤(癌症)患者之家