Melanoma after breast cancer, is there a relationship?

Melanoma after breast cancer, is there a relationship?

Last summer she discovered breast cancer during a routine screening mammogram. And now, just six months later, comes the diagnosis of melanoma. This is what happened to the Duchess of York Sarah Ferguson, 63 years old: according to the Guardian, the duchess’s spokesperson announced that several moles were removed and analyzed during the post-mastectomy reconstructive surgery, and that one of these was found to be a melanoma. Could there be a link between the two tumors?

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The correlation between breast cancer and melanoma (and more)

“Obviously we cannot say anything about the specific case of the Duchess of York, except that her phenotype, i.e. very pale skin and red hair, leads to a greater predisposition to the development of skin tumors. It is therefore probable that there is no link between the two tumors. But, generally speaking, there may be a correlation between breast cancer and melanoma”, he explains to Salute Laura CortesiHead of the Simple Structure of Oncological Genetics at the Department of Oncology of the University Hospital of Modena.

Already in 2009, Cortesi and colleagues had conducted a study in the province of Modena to establish what the probability of developing a second primary tumor was, and of what type, after breast cancer. Out of a total of over 7,500 patients, 499 had developed another tumor and melanoma was among the most frequent. “We know that those who get breast cancer have a higher than average risk of developing another tumor, in particular melanoma, in the uterus, ovary and other breast – continues the expert – In that study, the frequency of melanoma was double that expected: it is a statistically significant increase, so there is certainly a correlation.”

The risk factors

But what could be the reasons for this correlation? “There may be several common risk factors: some tumors of the breast (those defined as luminal, HR+), of the ovary of the uterus and melanoma, for example, are linked to hormonal expression – replies Cortesi -. Starting from genetics, there are mutations in genes that can predispose to both breast cancer and melanoma. The genes most involved are BRCA2 and CDKN2A, although there are others as well. CDKN2A, in particular, is a gene that especially increases the predisposition to multiple melanoma and it is also secondarily associated with pancreatic and breast cancer, to a lesser extent.”

The suspicion of the genetic component

To suspect the presence of a genetic mutation, however, there are very precise clues that emerge from an in-depth investigation of the history of the patient and her family, such as the presence of multiple cases of tumors, the onset at a young age, the development of bilateral forms of breast cancer (i.e. in both breasts). Another, less well-known gene is BAP1, which however is mainly related to the rarer forms of uveal melanoma.

Don’t let your guard down

“Among the other factors that can explain the correlation – concludes Cortesi – there is also a risk associated with treatments for breast cancer, both radiotherapy (for the irradiated area) and systemic therapy”. This evidence should not alarm patients, but only make them more aware, as well as doctors, of the importance of not neglecting checks after treatment, both for breast cancer and for other tumors, and of not lowering one’s guard against prevention. In the case of melanoma and other skin cancers, for example, screening carried out by a dermatologist allows you to easily discover a suspicious lesion.

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