Double Primary Breast Cancer Research Articles

Double Primary Cancer: Breast Cancer and Gastric Cancer

Introduction: Breast carcinoma is the most prevalent malignancy and the second leading cause of cancer death in women, while multiple primaries are conditions where there is more than one synchronous or metachronous cancer in one individual. Double primary between breast carcinoma and colon cancer is a primary tumor with a high incidence, while breast carcinoma metastasis to the colon is a rare entity except for lobular histotype breast carcinoma. In this case report, a woman with double primary breast cancer is reported. Case Report: A 50-year-old woman came with complaints pain of the entire abdomen since 2 days before go to hospital, worsening when starting to eat, accompanied by nausea. The patient had a history of modified radical mastectomy (MRM) for indications of right breast carcinoma cT3N0M0. In addition, a history of ovarian carcinoma that had undergone chemotherapy was also found. On esophagogastroduodenoscopy examination, a gastric mass was found with ulceration and necrosis and a biopsy showed high-grade neuroendocrine carcinoma and adenocarcinoma. Conclusion: Breast malignancy can be invasive or non-invasive and can undergo metastasis. In addition to metastasis, cancer can also appear in two different places but histologically or morphologically different. This condition is called multiple primaries due to host, lifestyle, and environmental factors.

Clinical Research Progress of Double Primary Cancers of Breast and Lung with Breast Cancer as the First Primary Cancer

Clinical Research Progress of Double Primary Cancers of Breast and Lung with Breast Cancer as the First Primary Cancer

The prevalence of BRCA1/2 germline mutation in Chinese pan-cancer.

e13684 Background: Pathogenic variants in cancer predisposition genes BRCA1/2 confer susceptibility to breast and ovarian cancer and well-studied. But the characteristics of BRCA in other cancers is unknown, we identified and characterized BRCA germline variants in a large pan-cancer in China. Methods: NGS was performed on genomic DNA from 29,676 pan-cancer patients. Large fragment deletions were all verified by QPCR. We integrated guidelines of ACMG/AMP, ENIGMA and China expert consensus. Based on the in-house system, variants were interpreted one-by-one and classified into 5 grades: Benign (B), Likely Benign(LB), Variant of Uncertain significance(VUS), Likely pathogenic (LP), Pathogenic (P). Results: Among 29,676 patients, 300 BRCA1 mutations and 440 BRCA2 mutations were detected in our study. The proportion among P/LP/VUS/LB/B were 36.1%, 11.6%, 36.6%, 11.1% and 4.6%. Consistent with previous reports, the mutations spread around the whole genes. Missense and frameshift were most common types in BRCA1 (40%, 25.3%) and BRCA2 (42.3%, 29.3%). 192(25.9%) mutations were not reported in any of the databases. Among these newly reported mutations, 32 (16.7%) were classified as P, 62 (32.3%) LP and 98 (51%) VUS. Totally, 522 (1.8%) patients were identified with P/LP BRCA1/2 mutations. No founder mutations in Chinese population were defined, but BRCA1 5470_5477delATTGGGCA (I1824Dfs*3) and BRCA2 3109C > T (Q1037*) had the highest prevalence indicating the common P/LP mutations in Chinese. On the whole, BRCA-associated hereditary cancer harbored higher P/LP percent than other cancer types (11.1% vs 0.7%). Different distribution and percent were observed in BRCA1 and BRCA2, the P/LP mutations were found in double primary cancers of breast and ovary (76.9% vs 38.5%), followed by ovarian cancer (15.5% vs 6.3%), breast cancer(3.8% vs 4.0%), endometrial cancer(1.6% vs 2.4%), prostatic cancer(1.3% vs 1.9%), pancreatic cancer (0.3% vs 1.8%), biliary tract tumor (0% vs 1%), thyroid cancer (0% vs 0.9%), NSCLC(0.2% vs 0.5%) and colorectal cancer(0.08% vs 0.4%). Except for SNV/Indels, large range heterozygous deletions were found in 9 patients, including 4 (0.6%) OC, 4 (0.2%) BC and 1 NSCLC, almost all interfering with BRCA1. Conclusions: This analysis depicted a comprehensive landscape of germline BRCA1/2 variants in Chinese pan-cancer. Besides breast and ovarian cancer, lots of other cancers also harbor BRCA germline mutation, retrospective family history and hereditary cancer risk assessment needs further study.

P2.09-08 Correlation Between Hormone Receptor Expression and EGFR Gene Mutation in Lung Cancer Patients with Simultaneous Primary Breast Cancer

Double primary breast cancer (BC) and lung cancer (LC) is not uncommon but research is limited. To decipher the inner pathogenesis, relationship between hormone receptor (HR) protein expression and EGFR gene mutation was explored in the present study. Clinicopathological characteristics of 400 female patients with double primary BC and LC were analyzed, while another 114 patients with single LC were compared correspondingly. Tissue samples were obtained from enrolled subjects to detect EGFR mutation status by gene sequencing analysis, and estrogen receptor (ER) and progesterone receptor (PR) expression was determined by immunohistochemistry. Among 169 patients, synchronous and metachronous double primary BC-LC cases accounted for 39.1% and 61.0%, respectively. For most female LC patients with simultaneous primary BC, adenocarcinoma was the dominant subtype (95.1%). The positivity rates were 13% for ER and 13% for PR in lung tumor tissues of 200 double BC-LC patients, slightly higher than those in single LC patients. Among BC-LC patients with mutant EGFR, 48.2% were either ER-positive (30.6%) or PR-positive (30.6%). But for those without EGFR mutation, both ER and PR could not be detected in lung tumor tissue samples. χ2 testfurther confirmed a significantly positive correlation between ER, PR expression and EGFR mutation in lung tumor tissues in double primary patients (P < 0.05). However, such relationship could not be similarly observed in single LC cases. Besides, the presence of family tumor history was associated with the onset time of the two primary cancers. Double primary BC-LC patients have distinctive clinicopathological features. Expression of HRs (both ER and PR) significantly correlated with EGFR mutation status in their lung tumor tissues.

A Rare Case of Primary Breast Cancer with Isolated Renal Parenchymal Metastasis Mimicking Primary Renal Cell Carcinoma

Breast cancer is the most frequent cancer and the leading cause of cancer-related death among females. Up to 30 percent of women with early-stage, non-metastatic breast cancer at diagnosis will develop distant metastatic disease. Renal metastasis from the breast cancer is a rare entity. We report a case of synchronized double primary breast cancer with isolated solitary metastatic to the kidney. Non-specific symptoms were occurred in routine surveillance after 4 years of initial diagnosis. 3-phase-CT and 18-F FDG PET-CT was performed subsequently. Left radical nephrectomy was performed. The histo-pathological diagnosis with immunohistochemistry was confirmed the metastasis from breast cancer. Breast cancer metastatic to the kidney may present a solitary renal mass, which mimics a primary renal tumour.