Breast cancer in systemic sclerosis: Results of a cross-linkage of an Italian Rheumatologic Center and a population-based Cancer Registry and review of the literature

Colaci, Michele; Giuggioli, Dilia; Vacchi, Caterina; Lumetti, Federica; Iachetta, Francesco; Marcheselli, Luigi; Federico, Massimo; Ferri, Clodoveo

doi:10.1016/j.autrev.2013.09.006

Cited by 47 publications

(36 citation statements)

References 37 publications

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“…[28][29][30][31] In a 2013 meta-analysis, an increased cancer risk was found in patients with SSc for: lungs (OR 2.73), bladder (OR 2.80), and non-Hodgkin lymphoma/leukemia (OR 2.55). 30 In patients with SSc, many mechanisms have been speculated as contributing to cancer onset, including impaired clearance of carcinogens and DNA damage induced by reactive oxygen species.…”

Section: Discussionmentioning

confidence: 97%

Association of occupational exposure with features of systemic sclerosis

Marie

Ménard

Duval-Modeste

et al. 2015

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 97%

Association of occupational exposure with features of systemic sclerosis

Marie

Ménard

Duval-Modeste

et al. 2015

Journal of the American Academy of Dermatology

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“…Rheumatoid arthritis (RA) is associated with increased incidence of cancer, in particular lung cancer, Hodgkin’s and non-Hodgkin’s lymphoma 24 but it remains challenging to differentiate the effect of disease from that of immunosuppression that correlates with severity of inflammation. Systemic lupus erythematosus, RA, and Sjogren syndrome are all associated with increased risk of lymphoma 25 while systemic sclerosis is associated with increased risk of breast cancer 26 . With this background, definition of extraintestinal cancer risk in autoimmune diseases is important to define quantitatively in order to distinguish the risk associated with immunosuppressive therapies from the risk associated with the disease itself.…”

Section: Discussionmentioning

confidence: 99%

Mortality and extraintestinal cancers in patients with primary sclerosing cholangitis and inflammatory bowel disease

et al. 2014

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Introduction: Primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) frequently co-occur. PSC is associated with increased risk for colorectal cancer (CRC). However, whether PSC is associated with increased risk of extraintestinal cancers or affects mortality in an IBD cohort has not been examined previously. Methods: In a multi-institutional IBD cohort of IBD, we established a diagnosis of PSC using a novel algorithm incorporating narrative and codified data with high positive and negative predictive value. Our primary outcome was occurrence of extraintestinal and digestive tract cancers. Mortality was determined through monthly linkage to the social security master death index. Results: In our cohort of 5,506 patients with CD and 5,522 patients with UC, a diagnosis of PSC was established in 224 patients (2%). Patients with IBD-PSC were younger and more likely to be male compared to IBD patients without PSC; three-quarters had UC. IBD-PSC patients had significantly increased overall risk of cancers compared to patients without PSC (OR 4.36, 95% CI 2.99 – 6.37). Analysis of specific cancer types revealed that a statistically significant excess risk for digestive tract cancer (OR 10.40, 95% CI 6.86 – 15.76), pancreatic cancer (OR 11.22, 95% CI 4.11 – 30.62), colorectal cancer (OR 5.00, 95% CI 2.80 – 8.95), and cholangiocarcinoma (OR 55.31, 95% CI 22.20 – 137.80) but not for other solid organ or hematologic malignancies. Conclusions: PSC is associated with increased risk of colorectal and pancreatobiliary cancer but not with excess risk of other solid organ cancers.

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“…Adenocarcinoma was the most frequently histologic pattern found (16 patients, 76%). Interestingly, the diagnosis of SSc was made at an older age in those patients diagnosed of cáncer (66,4±11,7 vs 54,8±17,3 years old, p=0,019); An age older than 55 years old conferred a relative risk (RR) of cáncer of 1,69 1,26-2,25 in the global cohort and a RR of 3,26 1,99 in the female cohort. Although the association cancer and CCB did not reach statistical significance, the association CCB and female patients older tan 55 years elevate de RR of cáncer to 4,16 (0.96-17,95).…”

mentioning

confidence: 99%

“…In SSc the risk of cancer is increased, but the role that CCB can play is not clear, with contradictory data obtained so far. 1,2 Objectives: To analyse the role of CCB in the appearance of cancer in a cohort of patients with systemic sclerosis. Methods: Encoded patients under the diagnosis of SSc in our hospital from 1985 until December of 2017 were collected.…”

mentioning

confidence: 99%

AB0785 Red cell distribution width is a promising marker of pulmonary arterial hypertension in scleroderma-related disorders

Bellan

Sguazzotti

Piccinino³

et al. 2018

Scleroderma, Myositis and Related Syndromes

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BackgroundThe early identification of those Systemic Sclerosis (SSc) patients harbouring Pulmonary Arterial Hypertension (PAH) is a mainstay in the management of SSc. Novel biomarkers might improve the specificity of screening algorithms currently available.ObjectivesIn this study we aimed to test the potential diagnostic value of Red cell distribution width (RDW), which has been previously described as a potential prognostic marker in thromboembolic and idiopathic PAH.MethodsWe prospectively recruited 118 patients affected by Scleroderma related disorders (Mixed connective tissue disease N. 7, 5.9%; SSc N. 93, 78.8%; Scleroderma overlap syndromes N. 11, 9.3%, undifferentiated connective tissue diseases N. 7, 5.9%) in a PAH outpatient clinic of a University Hospital. All patients underwent an extensive clinical and laboratory evaluation and an echocardiographic examination; a right heart catheterization was performed in 13 patients according to clinical indication.ResultsAccording to echocardiography and right heart catheterization, 14/118 patients were diagnosed with PAH. Patients affected by PAH had a higher RDW (15 [13.4–18.9] vs. 13.9 [12.1–19.1]; p=0.005), despite similar haemoglobin levels between groups. Patients affected by PAH also showed a higher BNP plasma concentration (245.6 [81.6–494.3] vs. 60.3 [50.3–77.4]; p=0.0001) and lower platelets count [206 188–243 × 103/µl vs 240 [198–299] × 103/µ; p=0.04]. RDW was also directly related to ultrasound-assessed Pulmonary Artery Pressure (PAPs) (ρ=0.20; p=0.03) and DLCO corrected for haemoglobin (ρ=−0.30; p=0.001); finally, RDW was related to the mean PAP measured by right heart catheterization (ρ=0.65; p=0.015).ConclusionsRDW is an inexpensive, potentially useful marker in the detection of SSc-related PAH; its inclusion in screening algorithms could be considered to further improve their diagnostic performance.Disclosure of InterestNone declared

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Breast cancer in systemic sclerosis: Results of a cross-linkage of an Italian Rheumatologic Center and a population-based Cancer Registry and review of the literature

Cited by 47 publications

References 37 publications

Association of occupational exposure with features of systemic sclerosis

Association of occupational exposure with features of systemic sclerosis

Mortality and extraintestinal cancers in patients with primary sclerosing cholangitis and inflammatory bowel disease

AB0785 Red cell distribution width is a promising marker of pulmonary arterial hypertension in scleroderma-related disorders

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