title: [Uterine and ovarian metastases 28 years after the discovery of breast cancer].
abstract: BACKGROUND
  Breast cancer seldom leads to uterine metastases, but more frequently spreads to the ovaries.
  
  
  METHODS
  A 72 year-old woman treated 28 years earlier for a breast cancer (conservative treatment and ovarian castration through radiotherapy) presented with metrorrhagia. The hysteroscopy and uterine curettage were normal. Three months later she presented with bone pains and pain along the course of the femoral nerve. The clinical examination revealed the existence of left axillary and sub-clavicle adenopathies. A biopsy of the lymph nodes showed a lobular adenocarcinoma with positive hormonal receptors. The clinical and biological state of the patient improved under treatment with tamoxifen and aredia. Eight months later the patient complained of pelvic pains. The ultrasound examination showed a pelvic tumour situated at the fundus of an enlarged uterus, as well as peritoneal effusion. The patient underwent a total hysterectomy and multiple biopsies that revealed diffuse metastases of a lobular adenocarcinoma spreading to the neck and the body of the womb, the mesosalpinx, the left ovary and the epiploon. The patient died less than a year after the first symptoms had appeared.
  
  
  CONCLUSIONS
  Uterine metastases of extrapelvic origin are rare. Breast cancer is the first cause of this dissemination. It is generally invasive, lobular, and frequently spreads to the ovaries. In the case reported here, what is remarkable is the exceptionally long period between the discovery of a breast cancer and the apparition of metastases. Hence, in order to detect a primary or secondary ovarian or uterine cancer, it is important to emphasize the necessity of systematic pelvic examination in patients treated for breast cancer.
authors.affiliation: Service oncologie Centre hospitalier, Chambéry.
authors.forename: H
authors.initials: H
authors.lastname: Mohseni
authors.forename: P
authors.initials: P
authors.lastname: Truong
authors.forename: M
authors.initials: M
authors.lastname: Hadjseyd
authors.forename: A
authors.initials: A
authors.lastname: Grimonpont
authors.forename: A
authors.initials: A
authors.lastname: Dieny
authors.forename: I
authors.initials: I
authors.lastname: Mechin-Cretinon
authors.forename: P
authors.initials: P
authors.lastname: Chabert
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001706:Biopsy; D001943:Breast Neoplasms / Q000628:therapy; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000556:secondary*; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015907:Hysteroscopy; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000556:secondary*; D000077268:Pamidronate; D013629:Tamoxifen / Q000627:therapeutic use; D013997:Time Factors; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D004164:Diphosphonates; D013629:Tamoxifen; D000077268:Pamidronate