A new study has reported the characteristics and survival outcomes of 29 breast cancer survivors with ovarian metastases. Outcomes were compared between women who underwent surgical removal of ovarian tumors and nearby related metastases and those who did not undergo such surgery. The women were found to be more likely to have hormone receptor positive tumors, lobular breast cancer, bilateral breast cancer, and/or predisposing genetic factors than the general breast cancer population. They were also more likely to be premenopausal at breast cancer diagnosis. The median period between breast cancer diagnosis and ovarian metastasis was five years. Most of the women who developed ovarian metastases (75%) had no symptoms of ovarian disease, however advanced-stage pelvic spread or extra-abdominal metastases were found in 41.5% of them. Median survival time was approximately three years. Survival was found to improve significantly when surgery to remove as much of the tumor mass as possible was performed. The authors conclude that surgical removal of ovarian metastases tends to increase survival, which may be long in that case. The authors suggest that at the very least, surgery should include the removal of both ovaries, even when one ovary appears normal.
Study describes a unique group of survivors
Although this study was small, it describes a unique group of breast cancer survivors who are at heightened risk for ovarian metastases. It has been established that women with lobular invasive breast cancer are more likely to have hormone receptor positive and bilateral (i.e., cancer in both breasts) tumors and that lobular breast cancer is more likely to run in families, indicating predisposing genetic factors. However, lobular breast cancer is more common among older, postmenopausal women, whereas the study finds that premenopausal women are more likely to develop ovarian metastases. Therefore, we would suggest that, like women with BRCA1 or BRCA2 mutations, premenopausal women with lobular breast cancer be especially vigilant with respect to monitoring any possible ovarian cancer symptoms (fullness in the pelvis, abdominal bloating, pelvic pain, or persistent changes in bowel and bladder patterns) and follow through with testing, if appropriate. Note that hormone replaccement therapy increases the risks of both lobular breast cancer and ovarian cancer.
Foods to emphasize and foods to avoid
There are also some foods which are associated with reduced risk of ovarian cancer while also protecting against breast cancer (and, presumably, breast cancer recurrence). On the other hand, some foods promote both.
Foods that protect against both ovarian and breast cancer
While ginger appears to have promise in fighting both breast and ovarian cancer and is safe to include in the diet, not enough evidence is available for us to put ginger on our "recommended" list of foods.
Foods that can increase risk of both breast and ovarian cancer
- Bread, white
- Cheese
- Cured and salted meats
- Fish contaminated with PCBs
- Milk, including low-fat
- Pasta
- Salted fish
- Salted shrimp paste
- Soybean paste