AUTOIMMUNE PROCESSES AS PARANEOPLASTIC MA NIFESTATIONS IN FAMILIAL BREAST-CANCER

In two patients, mother and daughter, L with breast cancer a paraneopl astic syndrome of probably autoimmune pathogenesis developed in the co urse of the neoplastic disease. In the mother the cancer occurred when she was aged 51, first in the left and then, 4 years later, in the ri ght breast. A local recurrence 18 years later caused a pericardial eff usion and further tumour recurrences were associated with symptoms lik e those in Sjogren's syndrome, as well as bullous pemphigoid and polyn europathy. Antinuclear antibodies, extractable nuclear antigen antibod ies and rheuma factors were demonstrated in serum. Both symptoms and a ntibody titres regressed under treatment with tamoxifen and various cy tostatic drugs. The patient died aged 74 years. - The daughter underwe nt a lumpectomy for breast cancer when aged 39 years, followed by mast ectomy for local recurrence after 2 years. A further 2 years later she was found to be anaemic with a positive Coombs test (1 : 1024) and an tibodies against IgG and complement. Metastases developed later. In he r case, too, clinical and serological findings clearly regressed under treatment with tamoxifen and chemotherapy. She died, aged 45 years, f rom the consequences of further metastases.