Outcomes of women with metachronous breast and ovarian carcinomas.
BACKGROUND
Women with a history of breast cancer have a significantly increased risk of developing a second primary ovarian cancer and vice versa. We proposed to determine the characteristics and outcomes of women diagnosed with metachronous breast and ovarian cancer.


METHODS
Patients were identified from the Surveillance, Epidemiology, and End Results program database between 1988 and 2001. Kaplan-Meier and Cox proportional hazards regression tests were used to determine survival outcomes.


RESULTS
Of 704 women, 526 developed breast cancer then ovarian cancer (B-O) and 178 developed ovarian cancer then breast cancer (O-B). The mean age at diagnosis of the first cancer in the B-O versus O-B group was 60.3 versus 58.9 years, respectively (P = 0.23). Twenty-five percent of women in the B-O group had stage I-II ovarian cancer versus 63% in the O-B group (P < 0.001). The percentage of those with stage I-II breast cancer was 94% and 91% in the B-O versus O-B group, respectively (P = 0.13). Women in the B-O group had more high grade of ovarian cancer compared to those in the O-B group (P < 0.001). The mean time interval between diagnoses of breast then ovarian versus ovarian then breast cancer was 58 versus 56 months, respectively (P = 0.42).


CONCLUSIONS
In the largest series to date, we found that women diagnosed with ovarian cancer first had significantly more early stage and lower grade ovarian cancers with better survival compared to those with breast cancer followed by ovarian cancer. Since half of the women had their second cancer beyond 5 years, continued surveillance of these high risk patients is recommended.
Department of Gynecology and Obstetrics, Stanford Cancer Center, Stanford University School of Medicine, 875 Blake Wilbur Drive, MC 5827, Stanford, CA 94305, USA.
Wen-Shiung
WS
Liou
Chad A
CA
Hamilton
Michael K
MK
Cheung
Kathryn
K
Osann
Teri A
TA
Longacre
Nelson N
NN
Teng
Amreen
A
Husain
Frederick M
FM
Dirbas
John K
JK
Chan
D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000473:pathology; D011379:Prognosis; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology