Second primary malignancies associated with primary female breast cancer: a review of the Danbury Hospital experience.

Second primary tumors associated with breast cancer are well known. The purpose of this retrospective study is to review the Danbury Hospital experience with second primary tumors following or concurrent with a diagnosis of breast cancer. Eighty-three women with an initial diagnosis of breast cancer between 1970 and 1986 developed second primary malignancies, most commonly in the contralateral breast, followed by colon or rectum. The median time to second diagnosis was shorter for the colorectal group than for the other sites. The occurrence of a second primary malignancy in general seemed to be more likely in the postmenopausal group, and the presence of a family history of breast cancer in a first degree relative was more often associated with second primary malignancy located in the contralateral breast. Patients who had had systemic therapy showed a shorter mean interval to second diagnosis than those who had received local therapy alone among the subset of patients with a second malignancy in the contralateral breast. Additionally, there was no tendency to discover the second primary breast cancer at an earlier stage than the first. These results suggest the importance of bowel surveillance once a diagnosis of breast cancer is made. They also suggest the importance of contralateral breast surveillance, especially with a positive family history, and that current methods of surveillance need to be reevaluated.