Pancreatic cancer in breast cancer patients: Incidence and relation with hormone receptor status

Abstract

17079 Background: There has been a long-standing interest in the role of estrogens in pancreatic tumors and several reports regarding the expression of hormone receptors in pancreatic tumors and the relation between estrogen stimulation and the development of pancreatic cancer have been inconsistent . This raised questions about the increased risk of pancreatic cancer among breast cancer survivors and the possible role of antihormonal therapy in the prevention and treatment of these malignancies. Methods: The Tumor registry at the Ochsner Clinic Foundation in New Orleans was queried to identify new cases of pancreatic cancer among patients previously diagnosed with breast cancer. This was done by matching data on pancreatic and breast cancer diagnosed between January 1996 and January 2006. For each case of pancreatic cancer, data was collected from the initial breast cancer pathology report, this included : Cancer type, Grade, Estrogen Receptor status, Progesterone Receptor, HER- 2 Receptor status , BRCA gene mutation and cancer stage on diagnosis. Clinic notes and radiology reports were also reviewed to determine the presence of risk factors for pancreatic cancer, the interval of time between the two diagnosis and the stage of breast cancer at the time of diagnosis of pancreatic cancer. Results: A total of 2,669 breast cancer cases were reviewed and 5 cases of pancreatic cancers were found among patients with a previous diagnosis of breast cancer. In all these cases the breast cancer tumor was positive for Estrogen and Progesteron receptor and negative for Her2 overexpression. The incidence of pancreatic cancer in this subgroup of patients (Breast cancer, ER+,PR+, HER2-) was 1% much higher than the incidence in the general female population. Conclusions: In our experience patients with breast cancer might have a higher risk of developping pancreatic cancer. This is especially true for patients whose tumors over-express the estrogen and progesterone receptors and which do not over-express the Her2 receptor. Further studies are needed to evaluate the overall incidence of pancreatic cancer in this population and to determine the role of anti-hotmonal therapy in the prevention of these cancers. No significant financial relationships to disclose.