The most frequent site of ocular metastasis is the choroid. The occurrence of choroidal metastases has increased steadily due to the longer survival of metastatic patients and the improvement of diagnostic tools. Fundoscopy, ultrasonography, and fluorescein angiography are now complemented by indocyanine green angiography and optical coherence tomography. Choroidal tumor biopsy may also confirm the metastatic nature of the tumor and help to determine the site of the primary malignancy. There is currently no consensus on the treatment strategy. Most patients have a limited life expectancy and for these complex treatments are generally not recommended. However, recent advances in systemic therapy have significantly improved survival of certain patients who may benefit from an aggressive ocular approach that could preserve vision. Although external beam radiation therapy is the most widely used treatment, more advanced forms of radiotherapy that are associated with fewer side effects can be proposed in select cases. In patients with a shorter life expectancy, systemic therapies such as those targeting oncogenic drivers, or immunotherapy can induce a regression of the choroidal metastases, and may be sufficient to temporarily decrease visual symptoms. However, they often acquire resistance to systemic treatment and ocular relapse usually requires radiotherapy for durable control. Less invasive office-based treatments, such as photodynamic therapy and intravitreal injection of anti-VEGF, may also help to preserve vision while reducing time spent in medical settings for patients in palliative care. The aim of this review is to summarize the current knowledge on choroidal metastases, with emphasis on the most recent findings in epidemiology, pathogenesis, diagnosis and treatment.

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These results suggest that the hormone related molecular pathways that drive cancer progression might be different in AC and DC. The decrease in steroid synthesis related enzymes, together with up-regulation of the BCAR1-Src pathway, emphasizes the biological particularities of DC.

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Breast cancer in males is infrequent, representing 1% of all breast carcinomas, and less than 1% of all male cancers (1, 2), even if its incidence seems to be increasing (3-7). All studies regarding male breast cancer (MBC) are retrospective and specific recommendations are sparse. The general management of non-metastatic MBC is usually based on guidelines for female breast cancer (FBC). Surgery, chemotherapy and hormonal therapy are based on classical prognostic factors. After mastectomy, which represents the majority of cases, locoregional irradiation for MBC remains controversial. Some institutions recommend systematic postmastectomy irradiation considering that MBC is intrinsically more aggressive than FBC and that the ratio of tumor size to gland could lead to minimal surgical margins; others suggest that the natural history of MBC resembles that of postmenopausal female breast cancer and that the aggressiveness is biased by a more advanced stage at diagnosis (1, 2, 4). Institutions base their recommendations for MBC based on data established for females. We evaluated clinical practices and outcomes with respect to radiation therapy in MBC treated with locoregional irradiation in the adjuvant setting using a systematic literature review. Materials and MethodsOur systematic review of the literature was based on the Preferred Reporting Items for Systematic Reviews and meta-Analysis (PRISMA) recommendations (http://www.prisma-statement.org/). Data were selected from a search on PubMed during the period 1976 to 2017 and from references in identified articles, using the following search terms: "breast cancer", "men", "male", "radiotherapy"; articles published in English or French were included. Relevant articles were selected with the following inclusion criteria: non metastatic MBC, an original study with more 23This article is freely accessible online.

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The management of breast cancer in elderly women is going to be a major public health issue in a near future. The use of hypofractionated stereotactic radiotherapy is expanding but might be a priori not offered to older patients. We addressed the role of stereotactic radiotherapy (SBRT, 1–10 fractions) in elderly patients with breast cancer, in definitive, adjuvant and metastatic settings. Review of the literature. Of six series using SBRT for partial breast or breast boost irradiation and over 20 oligometastatic (brain, lung, liver, bone) SBRT series including patients aged ≥60 years old, no difference was found in term of efficacy (>80%) and toxicity (<5% G3-4) compared to the younger. Hypofractionation is also well adapted to the elderly, due to limited transportation-related fatigue. SBRT studies by age group are lacking. However, hypofractionated SBRT is particularly adapted to older patients with breast cancer, in term of efficacy and tolerability and should be encouraged rather than more morbid treatments whenever possible.