Synchronous and Metachronous Breast and Endometrial Cancer
RC Marques, F Silva, S Andre, A Felix. IPO Lisboa Francisco Gentil, Lisboa, Portugal
Background: Breast cancer(BC) and endometrial cancer(EC) are very common neoplasms but synchronous(SC) and/or metachronous(MTC) tumours are rare. The purpose of our study was to characterize these tumors regarding clinical/morphological and immunohistochemical profile.
Design: We retrieved 55 cases of MTC/SC tumours with paraffin blocks from a group of 11378 cases treated for BC and EC in our Institution. We performed immunohistochemistry for Mlh1, Msh2, Msh6, ki67, ER, p53, Rb, ErbB2.
Results: Tumours were MTC in 42 cases. BC was the first tumour(GroupI) in 28 patients and EC (GroupII) in 14. In the remaining 13 patients, tumours were SC(GroupIII). Ten patients had bilateral BC. Seven patients (7,2%) had family history of breast/uterine cancer (FHBUC).The mean age of onset of the first tumour was 66,8yrs and of the second was 70,2yrs (mean time between: 3,4yrs; 1-15yrs) without difference between Groups I, II and III. FHBUC patients were younger (mean:60,7yrs) than patients from other groups. All were postmenopausal and the interval between menopause onset and first cancer was smaller in GroupII (mean:11,8yrs) than in GroupI and III (mean:18,3yrs and 18,4yrs). The 5 and 10yrs survival was 75% and 31%, (identical for all Groups). In Group I, 20 women had tamoxifen therapy(Tx) before the appearance of EC. No differences were found regarding the time elapsed between tumors, age of patients and survival rates for patients with or without Tx. The prevalent histological type of BCwas invasive ductal carcinoma(81,8%) and of EC was endometrioid cancer(87,3%). The prevalent histological grade of BC was G2(58%) and of EC was G1(54,5%). No significant differences regarding histological type and grade, FHBUC and survival were found between Groups I, II and III. EC diagnosed before and after 5 years of Tx had a similar histological grade. Immunohistochemical results are shown in table 1. The loss of Rb and MSI-H was higher in Group III than other groups. FHBUC cases have high p53 expression.