Choroidal and Optic Disc Metastases from Breast Cancer and Their Response to Combination Pharmacotherapy with Tamoxifen, Cyclophosphamide Hydrate, Letrozole, and Bevacizumab

The purpose of this study was to report a patient with choroidal and optic disc metastases from breast cancer and the response to combination pharmacotherapy with tamoxifen, cyclophosphamide hydrate, letrozole, and bevacizumab. We report a case of a 51-year-old woman with a medical history of breast cancer treated with mastectomy at 16 years earlier followed by 5'-deoxy-5-fluorouridine and tamoxifen for 12 years, who has been followed by annual check-up, with no additional findings. Two weeks prior to her first visit to our hospital, she noted blurred and abnormal color vision and field loss in her right eye. Her right eye showed choroidal metastasis from breast cancer, with retinal detachment involving the macula and inferior periphery. Multiple metastases involving bones, lymph nodes in the mediastinum, ovaries, and pelvic nodes were diagnosed after ocular metastases were established. Combination therapy with tamoxifen, cyclophosphamide hydrate, letrozole, and bevacizumab was administered to the patient. The retinal detachment and optic disc metastasis improved dramatically. The patient underwent combination pharmacotherapy with tamoxifen, cyclophosphamide hydrate, letrozole, and bevacizumab, which was effective in the treatment of ocular metastases from breast cancer.