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Malignancy in rheumatic disease: interrelationships.

R P Sheon, A B Kirsner, P Tangsintanapas

    Journal of the American Geriatrics Society
    |January 1, 1977
    PubMed
    Summary
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    Inflammatory arthritis and malignancy can occur by chance or be causally linked. Arthritis patients with malignancy, especially women with asymmetric arthritis, require careful examination for breast cancer due to higher mortality risks.

    Area of Science:

    • Rheumatology
    • Oncology
    • Internal Medicine

    Background:

    • Inflammatory arthritis and malignancy are distinct patient populations.
    • Two groups exist: chance occurrence and potential causal link between rheumatic disease and cancer.

    Purpose of the Study:

    • To differentiate between incidental and potentially causal associations of inflammatory arthritis and malignancy.
    • To identify clinical features associated with a causal link and guide diagnostic and management strategies.

    Main Methods:

    • Retrospective analysis of patients with inflammatory arthritis and co-existing malignancy.
    • Categorization based on symmetry of arthritis, rheumatoid factor status, and temporal relationship between disease onsets.
    • Correlation of clinical presentation with malignancy type and patient outcomes.

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    Main Results:

    • Group 1: Symmetric polyarthritis (rheumatoid arthritis), positive rheumatoid factor, no temporal link to malignancy.
    • Group 2: Asymmetric arthritis, negative rheumatoid factor, close temporal link to malignancy, significantly higher mortality.
    • In women with asymmetric arthritis and malignancy, 80% had mammary carcinoma.

    Conclusions:

    • Inflammatory arthritis and malignancy can present as distinct clinical scenarios.
    • Asymmetric arthritis with malignancy suggests a potential causal link and warrants urgent investigation, particularly for breast cancer in women.
    • Early detection and management are crucial for improving outcomes in patients with a suspected causal relationship.