Gastrointestinal carcinomas occurring in breast cancer patients.

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.

Mondor's disease of the axilla: a rare complication of sentinel node biopsy.

Three cases of Mondor's disease of the axilla following sentinel lymph node biopsy (SLNB) are described. In all cases we used the combination of blue dye and radiocolloid, and complete axillary dissection was not performed. The numbers of lymph nodes removed in each case were five, four, and two, respectively. All the events of Mondor's disease resolved spontaneously or following a short therapy of anti-inflammatory agents.

The characteristics of malignant breast tumors in hormone replacement therapy users versus nonusers.

BACKGROUND: The purpose of this study was to investigate the characteristics of breast cancer in hormone replacement therapy (HRT) users vs. nonusers. METHODS: We investigated the characteristics of all patients between the ages of 50 and 75 years with breast tumors. Then, an age-adjusted group of 55 nonusers was chosen to match and compare with HRT users. RESULTS: Of the 243 patients available for evaluation, 55 (22.6%) used HRT. Disease stages in HRT users vs. nonusers were as follows: ductal carcinoma in situ (DCIS), 20% and 17.1%; stage I, 45.5% and 41.7%; stage II, 30.9% and 26.2%; stage III, 3.6% and 13.4%; and stage IV, 0% and 1.6% (P =.27). In the age-adjusted cohort, stages in nonusers were as follows: DCIS, 7.3%; stage I, 47.3%; stage II, 25.5%; stage III, 20%; and stage IV, 0% (P =.03). Tumor grades in HRT users vs. nonusers were as follows: grade I, 30.4% and 15.7%; grade II, 52.2% and 52.2%; and grade III, 17.4% and 32.1% (P =.035). Grades in cohort nonusers were as follows: I, 13.2%; II, 52.8%; and III, 34% (P =.05). In the invasive tumors, the positive estrogen receptor (ER) rates were 81.6% and 85.7% (P =.89); positive progesterone receptor (PR) rates were 53.1% and 54% (P =.95); and Her 2-neu positive rates were 18.4% and 17.6% (P =.95), respectively. No significant difference was found in intratumor DCIS, vascular invasion, and Ki-67 (P =.14,.9, and.79, respectively). The rate of lobular and favorable histological types was higher in the HRT user group: 26.6% vs. 15%. CONCLUSIONS: Breast tumors in HRT users vs. nonusers were of a significantly lower stage and grade and accounted for a higher number of favorable histological types, but all other parameters were similar in the two groups.