CLINICAL CHARACTERISTICS OF 2ND PRIMARY TUMORS FOLLOWING BREAST-CANCER

In the Multiple Primary Tumor Registry of the Northern Israel Cancer C enter we found 247 patients with breast cancer who developed a second primary tumor. The major sites of the second tumor were mainly the oth er breast (42%), colon (14%), ovary (8%), and endometrium (7%), Only 2 4% of the second tumors were diagnosed in asymptomatic patients on a r outine follow-up examination; 60% of these patients had contralateral breast cancer and 8% had colon cancer. More patients in this group had localized disease as compared to those diagnosed following appearance of symptoms. The time interval between the first symptoms suggesting malignancy and the diagnosis was longer than 6 weeks in 7%, as compare d to 24% in patients diagnosed with a single cancer. In 69 patients (3 0%), delay was found between the first medical consultation and diagno sis. The agents responsible for the delay were the specialist (32%), t he system and normal tests (54%), and the patients (8%). In the diagno sis of a single tumor, the physician and the patient shared a similar percentage of responsibility (29% and 33%). Educational efforts aimed mainly at physicians and patients regarding the early detection of sec ond primary tumors are advocated. Methods that have been proven to det ect cancer early, such as mammography, stool for occult blood, and sig moidoscopy, should be utilized in asymptomatic patients with single tu mors in the same way as in the healthy population.