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Synchronous and Metachronous Breast and Ovarian Cancers: Experience from a Single Tertiary Care Cancer Centre in India

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Abstract

Women with either breast cancer (BC) or ovarian cancer (OC) have a 1.5–2 times higher risk of developing the other. Discerning discrete primaries versus metastases from either can be challenging. Clinico-pathological and outcome details of patients diagnosed with both BC and OC from December 1994 to August 2018 were retrospectively evaluated at a single tertiary cancer centre. We report the pattern of presentation and recurrences with case-based illustrations. Out of 139 patients, presentation was BC-first in 66.2%, OC-first in 24.5% and synchronous cancers (SC) in 9.3% of women. The median age at diagnosis in BC-first, OC-first and SC was 42 years, 48 years and 49 years, respectively. The most common histological subtype was invasive breast carcinoma-no special type (74.8%) in BC and serous cystadenocarcinoma (81.3%) in OC. BC presented at an early stage in 67.6% while OC presented at an advanced stage in 48.2% of patients. Germline mutation results were available in 82% with 61.4% of the cohort exhibiting a mutation- BRCA1 mutation being the most common. The median time to development of second cancer was 77.4 months and 39.4 months in BC-first and OC-first, respectively. At a median follow-up of 9.47 years, disease-free survival was 32.6%, 32.4% and 30.8% in BC-first, OC-first and SC, respectively (p < 0.001). In hereditary breast and ovarian cancer, BC-first patients have a better prognosis while synchronous malignancies have worse oncological outcomes. Deaths are mainly due to OC progression. Appropriate surveillance and prophylactic intervention in young patients with breast cancer may improve overall outcomes.

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Acknowledgements

The names of the institutions at which the work was performed were Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India, and Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Navi Mumbai, India.

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Author notes

  1. Shalaka Joshi and Sridevi Murali-Nanavati contributed equally to this work.

Authors and Affiliations

  1. Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Dr E Borges Road, Parel, Mumbai, India, 40012

    Shalaka Joshi, Sridevi Murali-Nanavati, T. S. Shylasree, Jarin Noronha, Urvashi Jain, Anand Thomas, Nita S. Nair & Rajendra A. Badwe

  2. Clinical Research Secretariat, Tata Memorial Centre, Dr E Borges Road, Parel, Mumbai, India, 40012

    Rohini Hawaldar & Vaibhav Vanmali

  3. Department of Pathology, Tata Memorial Centre and Homi Bhabha National Institute, Dr E Borges Road, Parel, Mumbai, India, 40012

    Sagar Tripathi & Ayushi Sahay

  4. Clinical Cancer Genetics Laboratory, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), and Homi Bhabha National Institute, Navi Mumbai, India

    Pradnya Kowtal & Rajiv Sarin

  5. Department of Breast Surgical Oncology, Nanavati Max Super Speciality Hospital, Mumbai, India, 400056

    Sridevi Murali-Nanavati

  6. Guy’s and St Thomas’ NHS Foundation Trust, London, UK

    Urvashi Jain

  7. Breast Surgery, Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Parel, Mumbai, India

    Vani Parmar

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  1. Shalaka Joshi
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Contributions

Conception and design: Shalaka Joshi and TS Shylasree; administrative support: Rajiv Sarin, Pradnya Kotwal, Rohini Hawaldar and R. A. Badwe; provision of the study materials or patients: Shalaka Joshi, TS Shylasree, Nita Nair, Vani Parmar, Rajiv Sarin; collection and assembly of the data: Shalaka Joshi, Sridevi Murali-Nanavati, Anand Thomas, Urvashi Jain, Ayushi Sahay, Vaibhav Vanmali and Sagar Tripathi; data analysis and interpretation: Shalaka Joshi, TS Shylasree, Sridevi Murali-Nanavati, Rohini Hawaldar and Urvashi Jain; manuscript writing: Shalaka Joshi, Sridevi Murali-Nanavati, Ayushi Sahay and TS Shylasree; final approval of the manuscript: all authors.

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Correspondence to Shalaka Joshi or Rajiv Sarin.

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Joshi, S., Murali-Nanavati, S., Shylasree, T.S. et al. Synchronous and Metachronous Breast and Ovarian Cancers: Experience from a Single Tertiary Care Cancer Centre in India. Indian J Surg Oncol 14, 809–821 (2023). https://doi.org/10.1007/s13193-023-01749-1

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