Appearance of Paraneoplastic Rheumatic Manifestations of Mostly Fibromyalgia in Patients with Breast Cancer: Analysis of 401 Cases

Background: Occasionally rheumatologic syndromes are the presenting symptom of an underlying malignancy. Objectives: The main goal of this cross-sectional study was to determine the presence of rheumatic manifestations by age, gender, type of solid tumors, and the stage of disease. Methods: The patients who suffered from solid tumors and referred for first time chemotherapy, were studied. All the extracted data from the questionnaire was collected and analyzed using SPSS (2016) software. Results: Four hundred and one patients were studied. Sixty-four patients had rheumatologic manifestations. The most representative age group was 61 - 70 years, the most common rheumatologic manifestation observed was fibromyalgia (30 female and 4 male). Most rheumatic syndromes were observed in breast cancer (31 patients) and stage 4 of breast cancer was the most common stage (38 patients). The presence of associated rheumatologic manifestations was as follows: fibromyalgia (53.1%), arthropathy (15.6%), polymyalgia rheumatica (10.9%), Raynaud’s phenomenon (9.4%), frozen shoulder (9.4%) and hypertrophic osteoarthropathy (1.6%). In this study, with the exception of hypertrophic osteoarthropathy, rheumatic manifestation is more common in female patients. Conclusions: From the findings, most rheumatologic manifestations (RMs) are gender dependent. These results can be used as a tool for more effective treatment and monitoring clinical studies of RM in patients with solid tumors especially fibromyalgia and breast cancer. If there is early recognition of the disease, it will lead to timely diagnosis and it is essential to improve outcomes in patients with paraneoplastic syndromes. Therefore, rheumatologists must work closely with oncologists to identify those paraneoplastic syndromes.