Purpose To determine the initial presenting signs of uterine cancer in patients with a history of breast cancer.
Methods We performed a retrospective chart review of all patients undergoing surgery for uterine cancer at our institution from January 1998 through June 2004. Clinical and patient information, initial presenting sign, FIGO stage and histologic type were extracted from the medical records. Comparisons were done using Fisher's exact and trend tests.
Results 838 patients with a history of uterine cancer were identified. 106 (12.6%) had a history of breast cancer (Group A) and 732 (83.4%) did not (Group B). The majority of patients presented with post-menopausal bleeding or abnormal vaginal bleeding (PMB/AVB) (Group A: 75%, Group B: 85%). Patients in Group A were less likely to present with PMB/AVB compared to those in Group B (p=0.02). Unusual signs of uterine cancer in Group A were an abnormal pap smear (6), abnormal ultrasound (13), or abnormal clinical finding other than bleeding (7). The distribution of histology and stage of uterine cancers were similar in both groups.
Conclusion PMB/AVB is the most common presenting sign of uterine cancer. However, patients with a history of breast cancer may present with other less common findings more frequently than expected. Physicians caring for patients with a history of breast cancer should be aware of other presentations of uterine cancer and stress the importance of a complete annual gynecologic evaluation including a full history, pap smear and pelvic examination.