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A case of prolonged disease-free survival in a patient with choroidal metastasis from breast cancer

Nature Clinical Practice Oncology volume 6, pages 118–121 (2009)Cite this article

Abstract

Background A 57-year-old woman presented with distorted vision and decreased visual acuity (finger count only) in her left eye, 6 years after she had undergone a lumpectomy, lymph-node dissection, and radiation therapy for a 1.1 cm infiltrating ductal carcinoma of her right breast. A year before this presentation, she had completed 5 years of adjuvant tamoxifen therapy.

Investigations Physical examination, including a thorough ophthalmologic evaluation; laboratory investigations, ocular fluorescein angiography, ocular ultrasonography, head CT, chest X-ray, abdominal ultrasonography, bone scan, and bilateral mammography.

Diagnosis Choroidal metastasis from breast carcinoma, with no other evidence of disease recurrence.

Management Radiation therapy to the left eye followed by ongoing hormonal therapy with oral letrozole 2.5 mg daily for the past 9.5 years.

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Figure 1: Pretreatment color retinal photographs and fluorescein angiograms.
Figure 2: A post-treatment retinal photograph shows pigmentary changes after radiation, but normal optic nerve and no subretinal fluid.

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Acknowledgements

Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

The authors would like to thank the patient for agreeing to this case report. Written consent for publication was obtained from the patient. We would also like to thank Doug Nicholson and the administrative staff in the Ophthalmology Clinic (Sunnybrook Health Sciences Centre) for helping us to obtain the retinal images.

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Authors and Affiliations

  1. RW Jang is an internal medicine resident at the University of Toronto. M Doherty is a radiation oncologist at the Sunnybrook Health Sciences Center and an Assistant Professor at the University of Toronto. JJ Hopkins is an ophthalmologist and a retinal specialist at Retina Vitreous Associates. E Warner is a medical oncologist at the Sunnybrook Health Sciences Center and an Associate Professor at the University of Toronto, ON, Canada.,

    Raymond W Jang, Mary Doherty, J Jill Hopkins & Ellen Warner

Authors
  1. Raymond W Jang
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  2. Mary Doherty
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  3. J Jill Hopkins
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  4. Ellen Warner
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Corresponding author

Correspondence to Ellen Warner.

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The authors declare no competing financial interests.

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Jang, R., Doherty, M., Hopkins, J. et al. A case of prolonged disease-free survival in a patient with choroidal metastasis from breast cancer. Nat Rev Clin Oncol 6, 118–121 (2009). https://doi.org/10.1038/ncponc1294

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