title: Receptor characteristics of the second tumor in synchronous versus metachronous breast cancer.
abstract: Presently, there is no consensus on whether synchronous breast cancer has the same disease origin as the primary tumor, or if it is a completely independent second primary. This study explores this concept in both synchronous and metachronous breast cancer looking specifically at their receptor characteristics and level of differentiation. A retrospective chart analysis of 114 patients with synchronous or metachronous breast cancer treated at a single institution between January 1991 and March 2004 was done. Sixty-three per cent of the patients were diagnosed with metachronous breast cancer. Synchronous breast cancer was histologically more aggressive (P < 0.05) with a significantly higher number of patients having poorly differentiated tumors, a greater number of metastases involving a larger number of organs (P < 0.05), and lower average survival compared with the metachronous group (P < 0.005). Both the first and second tumor in both groups were similar in hormone receptor status, histologic subtype, and grade. Synchronous breast cancer is more aggressive and has a poorer outcome than metachronous breast cancer. Concordance in hormone receptor status, grade, and histologic subtype between different tumors within the same patient suggests, but does not completely support, a monoclonal origin. Analysis applied here is crude and more specific methods of analysis such as DNA microarray would be required to infer such a conclusion.
authors.affiliation: Department of Surgery, Providence Hospital and Medical Centers, Southfield, Michigan, USA. drhan@hotmail.com
authors.forename: Hanadi
authors.initials: H
authors.lastname: Bu-Ali
authors.forename: Melhem
authors.initials: M
authors.lastname: Solh
authors.forename: Arthi
authors.initials: A
authors.lastname: Kapur
authors.forename: Vijay
authors.initials: V
authors.lastname: Mittal
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D018567:Breast Neoplasms, Male / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000473:pathology* / Q000601:surgery; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone