This study addresses the clinical problem of the patient with
breast cancer that has been operated on for an ovarian mass. It specifies the spectrum of histopathologic diagnoses and the differentiating magnetic resonance imaging (MRI) features of ovarian masses with correlations between clinical features, histopathologic, and MRI findings. Sensitivity and specificity of MRI vs histopathology in diagnosing
malignancy are estimated. The study included 53 women with
breast cancer who underwent surgery for an ovarian mass. Complete medical records, US and MRI images for the ovarian mass, and histopathology slides of both breast and ovarian resection specimens were reviewed and analyzed retrospectively. Thirty-six (67.9 %) patients had benign masses, and 17 (32.1%) had malignant masses, of which 8 (15.1%) were primary ovarian
malignancies and 9 (17%) were metastatic from
breast carcinomas. There was a significant association between benign and primary malignant ovarian masses and stage II
breast cancer (P = .00). There was a significant association between metastatic ovarian masses and stage III to IV
breast disease (P = .00) and negative
estrogen receptor status (P = .05). Magnetic resonance imaging had a specificity of 91.7% and a sensitivity of 94.1% in diagnosing malignant ovarian masses. In conclusion, the spectrum of ovarian masses diagnosed in patients with
breast cancer is broad, including benign lesions, primary ovarian
malignancies, and breast
metastases. Knowledge of the imaging features may allow a specific diagnosis aiding in surgical planning. Despite the high specificity and sensitivity of MRI to differentiate benign from malignant lesions, the unique ability to differentiate between primary and metastatic
malignancies is conserved to histopathology.