Frontiers in Surgery (Jun 2022)

Synchronous Operable Pancreatic and Breast Cancer Without Genetic Mutation: A Literature Review and Discussion

  • Adam Ofri,
  • Adam Ofri,
  • Danika Zuidersma,
  • Connie I. Diakos,
  • Connie I. Diakos,
  • Amanda Stevanovic,
  • Matthew Wong,
  • Samriti Sood,
  • Jaswinder S. Samra,
  • Jaswinder S. Samra,
  • Jaswinder S. Samra,
  • Jaswinder S. Samra,
  • Jaswinder S. Samra,
  • Anthony J. Gill,
  • Anthony J. Gill,
  • Anthony J. Gill,
  • Anubhav Mittal,
  • Anubhav Mittal,
  • Anubhav Mittal,
  • Anubhav Mittal,
  • Anubhav Mittal

DOI
https://doi.org/10.3389/fsurg.2022.858349
Journal volume & issue
Vol. 9

Abstract

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BackgroundSynchronous cancers are rarely detected when working-up a patient for a primary cancer. Neoadjuvant management of synchronous breast and pancreatic cancers, without a germline mutation, has yet to be discussed. Two patients were diagnosed with synchronous breast and pancreatic cancers at our institution over the last decade. A literature review was performed to evaluate the current evidence stance.ResultsThe first patient was 61-years old and diagnosed with a HER2+ breast cancer. The second patient was 77-years old and diagnosed with a Luminal B breast cancer. The inability to provide concurrent breast and pancreatic neoadjuvant therapy for the HER2+ patient, resulted in upfront surgery. The second patient was able to have both cancers treated simultaneously - neoadjuvant chemotherapy to the pancreas, and neoadjuvant endocrine therapy to the breast.DiscussThere is no single neoadjuvant regimen that treats both pancreatic and breast cancer. The differences in breast cancer sub-types impacted our neoadjuvant options. Our recent experience led us to the hypothesis that breast cancer care dictates treatment, while pancreatic cancer determines survival. There is a significant paucity in the literature regarding synchronous breast and pancreatic cancer.

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