Risk of Gyn Cancer Increases After Diagnosis of Breast Cancer

SAN FRANCISCO--Women with breast cancer are at higher risk ofdeveloping a second gynecologic cancer than women who do not havethe disease, Eva Chalas, MD, reported at a poster session of theSociety of Gynecologic Oncologists meeting. Close gynecologicmonitoring in the first 3 years after a breast cancer diagnosisis essential, she said.

"This has been demonstrated extensively in the scientificliterature," Dr. Chalas said, "and suggests that thereis a genetic linkage between breast cancer and colon, endometrial,and ovarian cancers."

Dr. Chalas and her colleagues at the State University of New Yorkat Stony Brook, where she is director, Division of GynecologicOncology, retrospectively reviewed the medical histories of 143breast cancer patients treated at Stony Brook from 1981 to 1994.The review focused on the women's ob/gyn histories and risk factorsfor gynecologic cancers.

Among these 143 patients, the researchers found 41 diagnoses ofgynecologic malignancies--18 ovarian, 16 endometrial, four cervical,and three other. The study also noted that the gynecologic malignancieswere most likely to appear during the first 3 years after theoriginal breast cancer diagnosis, she said.

"This indicates, in our opinion, that there is a sensitiveperiod of time during which these women need to be carefully monitoredfor gynecologic problems," Dr. Chalas said in an interviewwith Oncology News International.

Among the breast cancer patients who reported gynecologic symptoms,one third were found to have a gynecologic malignancy, and theprobability of finding such a malignancy was significantly higherin these women. "If women become symptomatic, they need tobe followed closely," she emphasized.

Although not every woman with breast cancer is necessarily athigher risk of developing a gynecologic malignancy, the studyfindings should alert breast cancer patients and their physiciansto that possibility and to the need to report gynecologic symptomspromptly, she said.

The results should also serve as a warning to postmenopausal womenwho think they no longer need gynecologic care. "Postmenopauseis the period during which gynecologic malignancies are most common,"Dr. Chalas said. "So while every woman should have routinegynecologic care, it is particularly important for women withbreast cancer."

She suggested that the organizers of large ongoing breast cancertrials, such as the Women's Health Initiative, consider utilizingtheir databanks to determine the actual incidence of gynecologiccancers in these women. "This is the only way that investigationsregarding the benefits of a close gynecologic follow-up of breastcancer patients can be effectively designed, and that each womancan be appropriately counseled," she said.