Clinical and pathological features of breast cancer in systemic sclerosis: Results from the sclero-breast study

Angela Toss, Amelia Spinella, Chrystel Isca, Caterina Vacchi, Guido Ficarra, Luca Fabbiani, Anna Iannone, Luca Magnani, Paola Castrignanò, Pierluca Macripò, Elisa Gasparini, Simonetta Piana, Laura Cortesi, Antonino Maiorana, Carlo Salvarani, Massimo Dominici, Dilia Giuggioli

Research output: Contribution to journalArticlepeer-review


Systemic Sclerosis (SSc) is a chronic disease associated with a 1.5-fold increase in cancer risk, including lung cancer, hematological malignancies, and breast cancer (BC). This is a retrospective study aiming to explore the clinical and pathological features of BC developed by SSc patients. A total of 54.5% of patients developed BC before SSc (median interval: 5 years), whereas 45.5% of patients developed BC after SSc (median delay: 8 years). A total of 93.1% of patients were diagnosed with an early stage tumor. Among invasive carcinomas, 70.8% presented with a low Mib1, 8.3% with a tubular histotype, and 42.8% with a Luminal A-like phenotype. A total of 66.6% of patients underwent breast-conserving surgery and 55.5% RT. A total of 40% of patients developed interstitial lung disease after RT and 20% diffuse cutaneous SSc. The cause of death of the six deceased patients was PAH. A significant association was observed between the use of immunosuppressive therapy and diffuse skin extension, negative ACA, positive Anti-Scl-70, and interstitial lung disease, but not BC status. SSc patients developed BC at a good prognosis, suggesting a de-escalation strategy of cancer therapies. In particular, ionizing radiation and chemotherapeuticals should be limited to higher-risk cases. Finally, proper screening is mandatory in order to allow for early cancer detection in SSc patients.

Original languageEnglish
Article number580
JournalJournal of Personalized Medicine
Issue number6
Publication statusPublished - Jun 2021


  • Breast cancer
  • Cancer screening
  • Clinical stage
  • Interstitial lung disease
  • Pulmonary arterial hypertension
  • Systemic sclerosis

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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