Breast Cancer Awareness…and the EYES?!
As many individuals are “making strides” this month to raise awareness and research dollars for breast cancer, I thought it appropriate to talkabout eyes.
You, however, are probably confused. What do breasts have to do with eyes?
It just so happens that breast cancer, followed by lung cancer, is the most common metastasis to the eye. Following the detection and diagnosis of an ocular metastasis, the question we must make sure we know the answer to is: Is there is a history of cancer? If the answer is “no” an immediate referral to an oncologist is indicated where a chest x-ray and mammogram should be performed.
On the other side of the token, if you have ever been diagnosed with breast cancer or have any history of cancer, the value of a dilated eye exam yearly CAN NOT be overstated. A reoccurrence or metastasis to the eye may give us clues to the activity of the cancer.
Additionally, the association between intraocular, brain, and central nervous system metastases is high, therefore full imaging of the brain is also indicated should any ocular metastases be detected.
The ocular manifestations are the only place in the body that we can measure and document with photography the appearance of said metastases. Often, after undergoing the appropriate systemic treatment (chemo or hormone therapy) the oncologist may refer back to an optometric physician to compare size and appearance of metastasis.
Breast cancer metastases differ in appearance to a primary ocular melanoma and tend to be multiple, thinner, and yellow in appearance, without disruption to the overlying retinal pigmented epithelium. An annual dilated eye exam is imperative as most ocular metastases are asymptomatic with no loss of vision.
When there are no symptoms involved and no loss of vision the primary goal is to systemically manage the condition with the oncologist with a thorough monitoring process of the ocular manifestations, but no specific treatment. Should the tumor threaten vision, radiation therapy is typically instituted.
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