Perrotin F, Marret H, Bouquin R, Fischer-Perrotin N, Lansac J, Body G
Département gynécologie obstétrique, reproduction humaine et médecine foetale, CHU Bretonneau, 37044 Tours, France.
Gynecol Obstet Fertil. 2001 Apr;29(4):308-15. doi: 10.1016/s1297-9589(01)00131-x.
Ovarian metastasis are frequently encountered during the course of breast cancer, concerning one woman in five among those suffering from the disease. These secondary ovarian lesions are usually small and bilateral with a non-cystic pattern and are more likely to be from primary infiltrating lobular carcinoma of the breast. Distinction between ovarian metastasis and primary ovarian cancer may sometimes be difficult and require immunohistochemical stains with various monoclonal antibodies. Primary ovarian cancer remains preponderant however, even in a woman with breast cancer. From a clinical point of view, ovarian metastasis are frequently unknown except in case of peritoneal dissemination. Trans-vaginal ultrasonography scan is the best examination when clinical signs give cause to suspect ovarian tumour. Although, systematic ultrasonography screening, as well as blood screening program using CA 125 and CA 15-3, should not be recommended because they lack sensibility and are too expensive. The development of ovarian metastasis during the course of a breast primary carcinoma is a negative prognostic factor with regards to the presence or absence of peritoneal dissemination.
在乳腺癌病程中,卵巢转移较为常见,在患乳腺癌的女性中,每五人就有一人出现这种情况。这些继发性卵巢病变通常较小,呈双侧性,无囊性特征,更可能源自乳腺原发性浸润性小叶癌。有时,区分卵巢转移瘤和原发性卵巢癌可能会很困难,需要使用各种单克隆抗体进行免疫组织化学染色。然而,原发性卵巢癌仍然占主导地位,即使在患有乳腺癌的女性中也是如此。从临床角度来看,卵巢转移通常不为人知,除非出现腹膜播散。当临床症状引发对卵巢肿瘤的怀疑时,经阴道超声扫描是最佳检查方法。不过,不建议进行系统的超声筛查以及使用CA 125和CA 15 - 3的血液筛查项目,因为它们缺乏敏感性且费用过高。在乳腺原发性癌病程中出现卵巢转移是关于腹膜播散有无的一个负面预后因素。