title: Synchronous Onset of Breast and Pancreatic Cancers: Results of Germline and Somatic Genetic Analysis.
abstract: BACKGROUND
  Synchronous cancers have occasionally been detected at initial diagnosis among patients with breast and ovarian cancer. However, simultaneous coexistence and diagnosis of breast and pancreas cancer has not previously been reported.
  
  
  METHODS
  Paternal transmission of a germline BRCA2 mutation to a patient who was diagnosed at age 40 with locally advanced breast and pancreas cancer is presented. Somatic genomic analysis of both cancers with next-generation DNA sequencing confirmed the germline result and reported a variety of variants of unknown significance alterations, of which two were present in both the breast and pancreas cancers.
  
  
  CONCLUSIONS
  The possibility that genomic alterations could have been responsible for modulating the phenotypic or clinical expression of this rare presentation is considered. The authors call attention to the practice of privatizing the clinicogenetic information gained from genetic testing and call for health policy that will facilitate sharing in order to advance the outcomes of patients diagnosed with hereditary cancers.
authors.affiliation: Personalized Cancer Medicine, PLLC, Honolulu, Hawaii, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Castro
authors.affiliation: Department of Pathology, Queens Medical Center, Honolulu, Hawaii, USA.
authors.forename: Koah
authors.initials: K
authors.lastname: Vierkoetter
authors.affiliation: Department of Radiology, Queens Medical Center, Honolulu, Hawaii, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Prager
authors.affiliation: Personalized Cancer Medicine, PLLC, Honolulu, Hawaii, USA.
authors.forename: Shasta
authors.initials: S
authors.lastname: Montgomery
authors.affiliation: Counsyl Inc., San Francisco, Calif., USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Sedgwick
keywords: BRCA2; Breast cancer; CREBBP; FAT1; Health policy; Hybrid capture; Next-generation sequencing; Pancreas cancer