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[941] Endometrial Serous Carcinoma Has a Strong Association with Breast Cancer, Particularly in Patients Younger Than 56 Years of Age

S Liang, M Pearl, C Tornos, E Chalas, M Kelly, P Schwartz, T Zhang, W Zheng. State University of New York, Stony Brook, NY; Yale University School of Medicine, New Haven, CT; Shangdon University, China; University of Arizona, Tucson, AZ

Background: Endometrial serous carcinoma (ESC) bears a poor prognosis and usually occurs in elderly women with average age of 65 years. However, some cases are seen in younger women. It is unknown whether the younger patients have any specific risk factors and a different prognosis than the older group. The purpose of this study was to investigate these two issues.
Design: Three hundred and twenty eight ESC including mixed tumors with more than 25% serous component were identified from our database (1995 2005). All cases (except 6) were surgically staged. Medical charts were retrospectively reviewed. The following information was recorded: age, history of breast cancer, family history of breast cancers, history of oral contraceptive pill (OCP), Tamoxifen or hormonal replacement therapy (HRT), and clinical follow-up.
Results: Thirty-nine patients (group A) were 56 years or younger (41-56, average 52.54y), and 289 (group B) older than 56 years (56-92, average 71.06y). All patients were postmenopausal except 17 (2 perimenopausal and 15 unknown). History of OCP use was noted in 12 patients. Breast cancer was seen in 15.5% (50/323) of patients (group A: 23.1%, and group B: 14.4%; p= 0.162). HRT was noted in 15.8% (26/165) patient (group A: 19.4 %; group B: 14.7%). In group A, 6 of 27 non-breast cancer patients (while 1 of 9 breast cancer patients) used HRT (p=0.399). Family history of breast cancer was present in 16.2% (24/148), and mostly in group B patients (20). Overall survival was 65.6 % at 32.3 months follow-up (group A: 73%, 32.2 m; group B: 64.4%, 32.3 m; p=0.307). The stage-matched survival between group A and B was: stage I: 88.9% vs. 87.9% (p=0.907); stage II: 83.3 % vs. 79.2% (p=0.819); stage III: 75% vs. 63.2% (p=0.634); and stage IV: 22.2% vs. 23.3% (p=0.941).
Conclusions: 15.5% of patients with ESC have a previous history of breast cancer. This association is even stronger in patients who developed ESC before age 56 years. There is no statistically significant difference in survival in both age groups, although the younger group seems to have a slightly better outcome. However, larger scale studies and longer follow-up are needed to further confirm the relationship between breast cancer and the development of ESC at a younger age.
Category: Gynecologic

Monday, March 26, 2007 9:15 AM

Platform Session: Section C, Monday Morning