Rare Case of Pleural Mesothelioma and Breast Cancer

In rare instances, people can have two different types of cancer at the same time. It is especially rare to have pleural mesothelioma and breast cancer.

One woman in Portugal was found to have this exact diagnosis. According to the authors who shared her case, she is the first published case of mesothelioma and breast cancer at the same time.

A Mesothelioma Diagnosis

Malignant mesothelioma is a rare form of cancer. It is caused by exposure to asbestos. This type of cancer forms on the lining of internal organs like the lungs.

There are three categories of mesothelioma: epithelial, sarcomatoid, and biphasic.

When mesothelioma forms on the lining of the lungs, it is called malignant pleural mesothelioma. It is the most common form of this cancer, accounting for 65-70% of all mesothelioma cases.

The risk of developing mesothelioma increases with age. It is also more common in men than in women. However, female patients usually survive longer than male patients.

The standard treatment for pleural mesothelioma includes surgery, chemotherapy, and radiotherapy. Even with this multimodal therapy, the treatment outcomes are usually poor.

In most cases where a patient has pleural mesothelioma and another cancer at the same time, the other cancer is also caused by asbestos exposure.

In this unique case, the patient instead had breast cancer. This is the most common cancer in women but had not yet been seen in a mesothelioma patient.

Treatment for Two Cancers

The woman in this case was 53 years old and still relatively healthy. In November 2020, a breast screening test revealed a suspicious area in her breast. To prevent the suspected breast cancer from spreading, she received a partial left mastectomy the following March.

After surgery, the patient started to receive radiotherapy and endocrine therapy. During the radiotherapy treatment, her doctors discovered the mesothelioma on her lung.

The patient’s care team decided to stop the radiotherapy and continue the endocrine therapy. They used exemestane, a drug that is commonly used to treat breast cancer.

The patient responded well to the exemestane dosage. After 14 months, she was not showing any symptoms of illness.

This is the first time that the effect of exemestane was observed in a pleural mesothelioma patient. It could provide a better treatment option for mesothelioma than chemotherapy.

Source

Pina M, Fernandes R, Fonseca D, Oliveira C, Rodrigues A. A Case Report of Mesothelioma Response to Endocrine Therapy in Synchronous Breast Cancer and Pleural Epithelioid Mesothelioma: A Double Exemestane Effect. Cureus. 2022;14(11):e31579. Published 2022 Nov 16. doi:10.7759/cureus.31579. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9757764/