Gastrointestinal Carcinomas Occurring in Breast Cancer Patients

Abstract

Breast cancer patients are reported to have a higher rate of second primary malignancies. We retrospectively reviewed the coexistence of breast and gastrointestinal (GI) tumors in the same patients and the characteristics of the tumors. The charts of all patients more than 35 years of age who were diagnosed with breast cancer and hospitalized for various reasons between 1985 and 2003 were reviewed and those who also had a diagnosis of GI malignancy were then selected. Age and tumor characteristics were evaluated. Out of all the patients, 2,650 had a diagnosis of breast cancer, while 40 (1.5%) also had GI malignancies. Among a comparable group of 70,784 consecutive female patients without breast cancer, 1,292 patients (1.8%) had a diagnosis of GI malignancy. The location of GI tumors in patients with both tumors was as follows: stomach, 6 (15%); right colon, 8 (20%); left colon, 7 (17.5%); sigma, 9 (22.5%); and rectum, 10 (25%). Seventeen of the patients (51.5%) had Dukes C and D tumors, 14 (42.5%) Dukes B, and 2 (6%) Dukes A or in situ. The stage of the others was not identified. The mean age at diagnosis of breast cancer was 68.5 years (range 48-88 years). In 23 (57.5%), GI cancer was diagnosed after breast cancer, in 7 (17.5%) it was diagnosed within 3 months of diagnosing breast cancer, and in 8 (20%) it was diagnosed prior to the diagnosis of breast cancer. Five patients suffered from an additional primary cancer: three endometrial, one lung, one esophageal, and one patient had two additional tumors in the endometrium and thyroid. We conclude that the rate of GI malignancies in breast cancer patients is slightly lower than in comparable patients without breast cancer. GI malignancies tend to be diagnosed later and are found more often in the distal colon.

Sporadic breast, ovarian, or uterine cancers as risk factors for colorectal cancer

“…Factors such as nonsteroidal anti-infl ammatory drugs (NSAIDs), HRT or tamoxifen use, obesity, or diabetes mellitus, did not appear to be confounding variables [26]. Lymph-node-negative patients did not appear to have an increased CRC risk above that expected based on age-specifi c SEER data, whereas the risk of gastrointestinal malignancies may be lower in breast cancer survivors over 35 years of age when compared with age-matched controls without cancer [21,27]. In contrast, two large population-based studies using similar European registries with a mean follow-up of 7.2 and 8.9 years, respectively, suggest that CRC risk increases with time in long-term survivors of breast cancer, with younger women having the greatest lifetime risk [20•,23].…”

Rare case of ER positive colorectal stricture demonstrating improvement with letrozole

“…GI metastases as a first presentation of breast cancer are rare2 and tend to present much later 3. Axillary lymphadenopathy is the usual presentation of occult metastatic breast cancer.…”

Mondor’s Disease

“…The etiology of this condition is still not clear, but it is frequently multifactorial. 1,2,3 The most common aetiopathogenic factors include traumatic events, excessive physical activity, surgical procedures, 4,5,6 compressive bandages or tight clothing, inflammatory process or infections 7 and benign or malignant breast tumors. Sudden onset of pain followed by the appearance of a tender, palpable cord is the most common presentation of Mondor's disease.…”