Risk of colorectal adenomas in women with prior breast cancer.
OBJECTIVE
Longer life expectancy in patients with prior breast cancer may increase their risk of developing other primary cancers, including colorectal cancer (CRC). Whether the risk of developing CRC in this patient population is higher in comparison to those with no prior cancer remains unclear. The purpose of this study was to compare the prevalence of colorectal adenomas and any CRC in breast cancer survivors with those who have no history of prior cancer and assess any difference with use of antiestrogen therapy.


METHODS
We compared the prevalence of colorectal cancer and adenomas in breast cancer survivors with that of a group of matched controls. Eligible survivors were ≤85 years of age; had initially been diagnosed with stage 0, I, II, or III breast cancer; had completed all cancer treatments with the exception of adjuvant antiestrogen therapy; and had no evidence of recurrence on follow-up. We used the screening colonoscopy database at our institution to identify age-, sex-, and race-matched controls with no history of cancer.


RESULTS
We identified 302 study-eligible breast cancer survivors and 302 matched controls. No colorectal cancers were found in either group. Forty-one breast cancer survivors and 30 controls had tubular adenomas; four survivors and three controls had villous adenoma; and eight survivors and ten controls had advanced adenoma. Multivariate regression analysis revealed that adjuvant antiestrogen therapy was not significantly associated with an increased risk of advanced adenoma.


CONCLUSIONS
The prevalence of colorectal adenomas in breast cancer survivors and controls was similar. Breast cancer survivors, including those receiving adjuvant antiestrogen therapies may follow the colorectal screening guidelines used for average-risk population.
Department of Medicine, University at Buffalo, 462 Grider Street, Buffalo, NY 14215, USA. ashukla2@buffalo.edu
Ashish
A
Shukla
Sandhya
S
Shukla
Ayodele
A
Osowo
Terry
T
Mashtare
Manoop S
MS
Bhutani
Sushovan
S
Guha
D000236:Adenoma / Q000150:complications*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000150:complications*; D020847:Estrogen Receptor Modulators / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016017:Odds Ratio; D012307:Risk Factors
D000970:Antineoplastic Agents; D020847:Estrogen Receptor Modulators