Clinicopathological Features And Prognosis Of Double Primary Breast And Ovarian Cancer

Objective: To evaluate the significance of early detection second cancer,the characteristics,clinicopathological features and prognosis of patients with double primary breast and ovarian cancer were systematically analyzed and discussed.Methods: A total of 49 patients with double primary breast and ovarian cancer diagnosed by the East Branch of the Fourth Hospital of Hebei Medical University on January 1,2010 and December 31,2020 were selected to analyze the incidence of such patients.According to the chronological sequence of the onset of breast cancer or ovarian cancer,the patients were divided into the first double primary cancer of breast cancer and the first double primary cancer of ovarian cancer.The clinical characteristics and surgical and pathological characteristics of the two groups were analyzed and compared,and the survival of the patients with the first double primary cancer of breast cancer was analyzed.According to the time interval of onset,the patients with double primary cancer of breast and ovarian were divided into synchronous double primary cancer and heterogenous double primary cancer,and the survival analysis of the patients with heterogenous double primary cancer was conducted.SPSS26.0 statistical software was used for analysis.Measurement data that met the normal distribution was represented as mean ± standard deviation(X±S),while those that did not were represented as median.Student t test or Mann-Whitney U test was used for comparison between groups.Enumerate data were expressed as cases(n)or percentage(%),and comparison between groups was analyzed by Chi-square test or Fisher’s exact test.Kaplan-Meier method was used for survival analysis.P < 0.05 was considered statistically significant.Results:1.Basic data: 49 patients with double primary breast and ovarian cancer,the main pathological type of breast cancer was invasive ductal carcinoma,and the main pathological type of ovarian cancer was serous carcinoma.Breast cancer was the primary cancer in 32 cases and ovarian cancer in 17 cases.There were 42 cases of metachronous double primary breast and ovarian cancer,and only 7 cases of synchronous breast and ovarian cancer.In the whole group,40.8% of the patients with double primary cancer had a family history of cancer,and 44.9% of the patients were non-menopause when the first cancer was found.2.Age and both primary cancer onset inverval: The median age at diagnosis for breast cancer was 47.5 years(34.0-64.0 years)and for ovarian cancer 53.5 years(42.0-68.0 years)in the first-onset breast cancer group.For patients with first-onset ovarian cancer,the median ages at diagnosis of ovarian cancer and breast cancer were 48 years(39.0-60.0 years)and 52.0years(45.0-66.0 years),respectively.In the first-onset breast cancer group,the mean interval between the two primary cancers was 52.75 months(median 46 months,range 3-130 months);In the first-onset ovarian cancer group,the mean time between the two primary cancers was 89.71 months(median,78 months;range,4-131 months).The time interval from the first cancer to the second primary cancer was statistically significant between the two groups(P= 0.038).Among the 32 patients in the first breast cancer group,the second primary cancer occurred0-5 years after the diagnosis of breast cancer in 20 cases,5-10 years after the diagnosis in 10 cases,and > 10 years in 2 cases.Among the 17 patients in the first ovarian cancer group,there were 9 cases of second primary cancer 0-5years after ovarian cancer diagnosis,4 cases 5-10 years after ovarian cancer diagnosis,and 4 cases of > 10 years after ovarian cancer diagnosis.3.The clinical characteristics and surgical-pathological features: There were significant differences in menarche age,family history,menopause at the time of diagnosis of the first-episode cancer,time interval between the onset of the two primary cancers,bilateral nidus lesions,ovarian cancer staging and surgical methods between the two groups(P < 0.05).For the stage of ovarian cancer,the proportion of different stages of ovarian cancer in the first breast cancer group was 6.2%,15.6%,59.4% and18.8%,respectively.The proportion of different stages of ovarian cancer in the first-episode group was 52.9%,35.3%,11.8% and 0%,respectively.A 3-year OS analysis was conducted for the patients with double primary cancer in the first breast cancer group.4.Survival analysis:The 3-year OS of the 16 patients in the first breast cancer group was 56.3%.Due to the small sample size and small number of events in the dual primary cancer group in the first-episode ovarian cancer group,survival analysis was not performed for this group.A 3-year OS analysis was performed on the patients with synchronous double primary breast and ovarian cancer.The 3-year OS of 15 patients with synchronous double primary breast and ovarian cancer was 60.0%.Due to the small sample size and small number of events in the group of patients with simultaneous double primary breast and ovarian cancer,survival analysis was not performed in this group.Conclusion:1.The incidence of heterochronous double primary breast and ovarian cancer is higher and better prognosis than that of synchronous double primary cancer.2.The interval of onset of double primary cancers in the first-episode breast cancer group was shorter than that in the first-episode ovarian cancer group.3.Patients with first-episode breast cancer were more likely to have advanced(stage III and IV)ovarian cancer,while patients with first-episode ovarian cancer were more likely to have early(stage I and II)ovarian cancer.4.Early stage(stage I and II)ovarian cancer patients should be screened for breast cancer,and the screening duration should be more than 5 years.5.Women with a positive family history of breast cancer and a BRCA1/2gene mutation should have their ovaries clinically monitored to prevent ovarian cancer.