Melanoma risk in women with previous breast cancer.
R. Weitzen, G. Harari, A. Achiron, R. Catane, M. Mandel;
Sheba Medical Center, Oncology Institute & Blood Bank, Ramat Gan, Israel
Abstract: Background: Four cases of double primaries (melanoma and breast cancer), which were treated in our institute, raised our attention to the risk of both tumors in women.
Our objective was to determine the risk for development of melanoma or breast cancer as second primary tumor in women with either one of them.
Methods: We considered 51,000 breast cancer women patients and 6248 malignant melanoma women registered by the Israel Cancer Registries (6,000,000 inhabitants) and followed up from 1960 to 2000.
Results: Overall, 276 malignant melanoma women were observed in the subpopulation of breast cancer versus 157 expected [standardized incidence ratio (SIR): 1.76; 95% confidence interval (CI) 1.50-2.05].
The incidence for breast cancer (276) in the sub population of melanoma females was as expected (267) with SIR 1.03 (95% CI 0.91 -1.17). Interestingly most women had been diagnosed with the second primary within the 12 months after diagnosing the first primary.
The SIR for melanoma in the sub population of females with breast cancer (43 observed versus 19 expected) during 1 year after diagnosis of breast cancer was 2.28 (95% CI 1.39 -3.50). The SIR for breast cancer (44 observed versus 20 expected) in subpopulation of females up to one year after diagnosing of melanoma was 2.21 (95% CI 1.36 -3.35).
Conclusions: We report excess risk of melanoma in women with breast cancer. Most of the cuetaneous tumors were discovered during the first year after diagnosis of the breast cancer.
Although there is no excess risk for breast cancer in melanoma patients we observed that during the first year after diagnosing the melanoma there were double observed cases than expected. These findings suggest the possibility that more intense follow up lead to diagnosis of both second primary tumors.
Genetic susceptibility might be responsible for the excess risk.
Recommendation: Women with either breast cancer or melanoma and their clinicians should be aware of the reciprocal higher risk for both tumors. Skin and breast examination should be performed after diagnosing one of the primaries.
Abstract No: 7553
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