Management of choroidal metastases from breast carcinomas using aromatase inhibitors.

PURPOSE OF REVIEW

The outcome of patients diagnosed with uveal metastases from breast carcinoma, all of whom were treated with one of the new generation of hormone therapies named aromatase inhibitors, is reported.

RECENT FINDINGS

Charts of all patients with uveal metastases from breast cancer seen at Wills Eye Hospital between 1995 and 2005 are reviewed. Seventeen patients were diagnosed with uveal metastases from estrogen-receptor-positive breast cancer and subsequently treated with one of the aromatase inhibitors (anastrozole, letrozole, exemestane).

SUMMARY

The interval between initial diagnosis of breast cancer and choroidal metastases ranged from 1 month to 17 years. Thirteen patients had received tamoxifen either at the time of breast surgery or as part of the metastases treatment. In 10 cases, both the systemic and choroidal metastases remained regressed over a mean of 20 months follow-up (4-50 months). There was no toxicity or intolerance to the medication. Aromatase inhibitors represent a new generation of hormone therapy for metastatic breast cancer. They were effective in 59% of the patients with estrogen-receptor-positive breast cancer, many of them nonresponding to prior treatment with tamoxifen. Aromatase inhibitors avoid the need for external beam radiation therapy as a treatment for the ocular metastases.