Hidden estrogen production from ovarian remnants leading to progression of disease in metastatic breast cancer

• Published in: The breast journal Vol. 24; no. 4; pp. 642 - 643
• Main Authors: Weiner, Ashley, D'Andrea, Gabriella M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.07.2018
• Subjects: Adult; Anastrozole - therapeutic use; Aromatase Inhibitors - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Cancer; ER positive breast cancer; Estrogen receptors; Estrogens; Estrogens - metabolism; Female; Health risk assessment; Hormone replacement therapy; Humans; International trade; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - secondary; Metastases; metastatic breast cancer; Ovarian Diseases - surgery; ovarian remnant syndrome; Ovariectomy; Ovariectomy - adverse effects; Patients; Positron Emission Tomography Computed Tomography; Receptor, ErbB-2; Syndrome; ovarian remnant syndrome; ER positive breast cancer; metastatic breast cancer
• ISSN: 1075-122X; 1524-4741
• DOI: 10.1111/tbj.12972

In premenopausal women with hormone dependent breast cancers, ovarian suppression is an important part of treatment, and is often achieved with a bilateral salpingo‐oophorectomy (BSO). However, this procedure can lead to ovarian remnant syndrome (ORS), a rare condition where the adnexal tissue is not completely removed and can produce estrogen. We describe a case of ORS in a patient with estrogen receptor positive (ER+) breast cancer who had progression of disease after undergoing a BSO, despite optimal therapy. ORS therefore poses a significant treatment challenge in premenopausal ER+ breast cancer patients thought to be rendered menopausal with a BSO.