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A comparative study between endometrial serous carcinoma (ESC) and endometrial endometrioid carcinoma (EEC) was performed to determine whether a personal history of breast cancer is a risk factor for ESC in women aged 55 yr. Study subjects consisted of 348 women who were diagnosed with ESC and 830 comparison subjects who had EEC. Variables studied included age at diagnosis, a history of breast cancer, tamoxifen therapy, hormonal replacement therapy and smoking history. Overall, 19.4% of women with ESC had a history of breast cancer, which was significantly higher than that of 3% in comparison subjects. Among the study subjects, the incidence of a prior breast cancer was significantly higher in patients who were 55 yr of age or younger (41.5%) than those who were older than 55 yr (16%). The statistical significance of both of the aforementioned comparisons was independent of tamoxifen usage on multivariate analyses. The mean time interval between prior breast cancer and endometrial cancer was 92.5 mo (range 7-240 mo) in the study group and 79 mo (range 7-192 mo) in the comparison group. For the whole cohort and individual subgroups (ESC, EEC, 55 yr and >55 yr), a personal history of breast cancer did not adversely affect the patient outcomes, which was largely dependent on standard clinicopathologic parameters such as International Federation of Gynecology and Obstetrics stage, as has previously been demonstrated. These findings suggest that a personal history of breast cancer may be a significant risk factor for the development of ESC in women aged 55 yr. Further studies are needed to clarify the relationship between these two cancers in this age group and whether this increased risk is reflective of a genetic predisposition.Endometrial carcinoma is the most common malignancy of the female genital tract in the United States.1 This neoplasm represents a relatively heterogeneous group of diseases regarding epidemiology, molecular abnormalities and biologic behavior 2 but can in general be classified into two subtypes, Type I or Type II.3 Endometrial endometrioid adenocarcinoma (EEC) is the prototype of the Type I carcinoma, is the most common histologic subtype of all endometrial malignancies and, overall, has a fairly good prognosis. The development of EEC has been attributed to hyperestrogenism related to a myriad of conditions that range from endogenous (anovulatory cycles, obesity, diabetes and hormone-producing neoplasm) to exogenous [unopposed hormonal replacement therapy (HRT) and use of fertility drugs] to physiologic (late menopause). 4 Unlike EEC, endometrial serous carcinoma (ESC) or uterine papillary serous carcinoma, 5 a prototype of the Type II carcinoma, is less commonly seen but bears a significantly worse prognosis.6-9 Despite numerous research efforts in the past two decades, no clear risk factors have yet been identified for ESC or other variants of Type II endometrial cancers, including clear cell carcinoma (CCC).

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