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    Pea sized, very dark growth on labia
    An_249464 posted:
    I just noticed last night this round, pea-sized, black growth on my labia. I've already had invasive lobular carcinoma and gone through a double mastectomy, chemo, radiation, and 5 reconstructive surgeries, so you may be able to imagine how worried I am right now.. I feel certain it was not there a week ago which means it's very fast growing. I plan on calling my internist first thing Monday but wonder if my dermatologist should see it - or my oncologist. I am hoping that a medical person out there will see this and guide me and also offer me some information of what this may be. My great fear is melanoma.
    Thanks in advance for any help you can offer.
    Jane Harrison Hohner, RN, RNP responded:
    Dear An: Anyone of your MDs can do a biopsy to assess the source of the lesion. In my OPINION, a derm MD (or GYN oncologist) would be my choice to do both the initial biopsy and full excision--if needed.

    Here is a citation from the National Library of Medicine site:

    J Clin Oncol. 2008 Mar 10;26(:1239-46.

    Risk of new primary nonbreast cancers after breast cancer treatment: a Dutch population-based study.
    Schaapveld M, Visser O, Louwman MJ, de Vries EG, Willemse PH, Otter R, van der Graaf WT, Coebergh JW, van Leeuwen FE.

    Comprehensive Cancer Center North-Netherlands (CCCN), P.O. Box 330, 9700 AH Groningen, The Netherlands.


    To assess the risk of secondary nonbreast cancers (SNBCs) in a recently treated population-based cohort of breast cancer patients focused on the association with treatment and prognostic implications.

    In 58,068 Dutch patients diagnosed with invasive breast cancer between 1989 and 2003, SNBC risk was quantified using standardized incidence ratios (SIRs), cumulative incidence, and Cox regression analysis, adjusted for competing risks.

    After a median follow-up of 5.4 years, 2,578 SNBCs had occurred. Compared with the Dutch female population at large, in this cohort, the SIR of SNBCs was increased (SIR, 1.22; 95% CI, 1.17 to 1.27). The absolute excess risk was 13.6 (95% CI, 9.7 to 17.6) per 10,000 person-years. SIRs were elevated for cancers of the esophagus, stomach, colon, rectum, lung, uterus, ovary, kidney, and bladder cancers, and for soft tissue sarcomas (STS), melanoma, non-Hodgkin's lymphoma, and acute myeloid leukemia (AML). The 10-year cumulative incidence of SNBCs was 5.4% (95% CI, 5.1% to 5.7%). Among patients younger than 50 years, radiotherapy was associated with an increased lung cancer risk (hazard ratio [HR> = 2.31; 95% CI, 1.15 to 4.60) and chemotherapy with decreased risk for all SNBCs (HR = 0.78; 95% CI, 0.63 to 0.98) and for colon and lung cancer. Among patients age 50 years and older, radiotherapy was associated with raised STS risk (HR = 3.43; 95% CI, 1.46 to 8.04); chemotherapy with increased risks of melanoma, uterine cancer, and AML; and hormonal therapy with all SNBCs combined (HR = 1.10; 95% CI, 1.01 to 1.21) and uterine cancer (HR = 1.78; 95% CI, 1.40 to 2.27). An SNBC worsened survival (HR = 3.98; 95%CI 3.77 to 4.20).

    Breast cancer patients diagnosed in the 1990 s experienced a small but significant excess risk of developing an SNBC.

    An_249464, here is one specific to melanoma:

    Cancer Prev Res (Phila). 2012 Jan;5(1):82-8. doi: 10.1158/1940-6207.CAPR-11-0332. Epub 2011 Sep 20.
    Antiestrogen therapy for breast cancer modifies the risk of subsequent cutaneous melanoma.
    Huber C, Bouchardy C, Schaffar R, Neyroud-Caspar I, Vlastos G, Le Gal FA, Rapiti E, Benhamou S.

    Geneva Cancer Registry, Institute for Social and Preventive Medicine, University of Geneva, 55 Boulevard de la Cluse, Geneva, Switzerland.

    Increased risk of secondary melanoma after breast cancer has been reported. Several lines of evidence suggest that elevated estrogen levels may be implicated in melanoma etiology. Accordingly, use of antiestrogens should be associated with decreased risk of melanoma. We compared melanoma incidence among a cohort of breast cancer patients with and without antiestrogen therapy, with data from the Geneva Cancer Registry. The cohort consisted of 7,360 women diagnosed with breast cancer between 1980 and 2005. About 54% of these patients received antiestrogens. All women were followed until December 2008. We compared cutaneous melanoma incidence rates among patients with and without antiestrogens with those expected in the general population by age and period standardized incidence ratios (SIR). A total of 34 women developed a melanoma during the follow-up period. Compared with the general population, the risk of melanoma was higher for patients who did not receive antiestrogens (P = 0.02).....


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