Pss And Breast Cancer

An additional type of malignancy frequently reported with PSS is breast carcinoma. Several cases are cited where the two diseases developed within months of one another [10-12], In a 1979 study [1], an even greater incidence of breast carcinoma in association with PSS than lung carcinoma was found.

Occasionally, a worsening of the scleroderma was noted when the malignancy recurred, while improvement of skin changes occurred after treatment of the neoplasm [10]. (A similar finding was also noted in connection with bladder carcinoma [10].) An incidence of breast cancer of up to 17% of all types of neoplasms in PSS is mentioned in several studies.

In a number of cases the breast carcinoma was diagnosed after the onset of PSS, whereas, in others the scleroderma developed after the diagnosis and treatment of the malignancy (mastectomy/lumpectomy and radio- or chemotherapy). There is no consistent connection between immunosuppressive therapy for scleroderma and the appearance of malignancy. Contrary, scleroderma (localized and systemic) has occasionally developed after radiotherapy for breast cancer. In these cases it is unclear whether the collagen disease may be connected to the malignancy itself, or to the radiation.

The explanation suggested for the association of lung carcinoma and PSS is that the fibrosed pulmonary tissue represents a "fertile" ground for the ensuing of the neoplastic changes, eventually giving rise to the cancer. No similar association was found between breast cancer and scleroderma since the two conditions were often diagnosed a few months apart, suggesting a possible common etiology and not a co-dependence. It may be argued that in the few cases when the scleroderma developed after radiotherapy for breast cancer, the radiation may have provided the trigger for the collagen disease.

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