Synchronous breast and colon cancer: the importance of multidisciplinary team cancer meetings

Abstract

A 58-year-old female patient presented with left breast lump. Mammography and ultrasonography were performed, which reported lesions suspicious of malignancy in the left breast and axilla. Core biopsy of the lesions revealed invasive ductal carcinoma with axillary lymph node metastasis. Staging CT scan (thorax, abdomen and pelvis) identified a coexisting neoplasm in the ascending colon. Colonoscopy was performed and the tumour in the ascending colon was biopsied. Histopathological examination revealed adenocarcinoma. In the multidisciplinary team cancer meeting, it was decided to treat the breast cancer first and then the colon cancer, followed by adjuvant chemotherapy. In the first operation, left modified radical mastectomy was performed. Two weeks after her initial operation, the patient underwent laparoscopic right hemicolectomy. Postoperatively, the patient did not develop any complications and was referred to oncology for chemotherapy.

Metastatic Sigmoid Colon Malignancy With a Synchronous Carcinoma Breast: Is Cure Possible?

“…Acceptable and reasonable clinical decision-making would suggest that the therapy is guided by the more advanced or more aggressive tumor. Some groups opine that a less morbid surgery should be undertaken initially to complete the next surgery in a shorter time frame [ 4 ]. Simultaneous resections for both malignancies have been reported by a few [ 5 , 6 ].…”

“…Third, would the adjuvant chemotherapy in such a patient be different or extended than a patient who had cancer in isolation? Few of the reports that have discussed the adjuvant therapy have mentioned no change in the protocol, and the systemic therapy was directed to the malignancy with an advanced stage [ 4 , 7 ]. Similarly, our patient had breast cancer with no poor prognostic factor hence only hormonal therapy was considered.…”