Dermatomyositis cancer screening

The Chances of cancer occurrence in dermatomyositis - elder patient (more than 65 year) is about 48% and very low chance in young and middle age patient approximately 9%. Must common cancers associated with dermatomyositis are ovarian cancer, breast cancer, cervical cancer , lung cancer, bladder  cancer,  stomach cancer,  pancreas cancer, colorectal cancer and kidney cancer. highly incidence in male patient.

Cancer  screening   in dermatomyositis  Patients include :

• Family / Medical History : Ask for autoimmune disease, relatives involvement .

• Physical exam: Examiner will take patient vitals, Auscultate heart and lung sound, inspect for swelling , tumor, skin color changes, scars,  palpation (superficial and deep) of abdomen, percuss and auscultate for bowel movement. Perform digital rectal examination to rule out colorectal cancer. Check for lymphadenopathy, Breast examination for lumps, inverted nipples and discharge of blood from nipples. 

• Breast MRI often used for women who have mutation of BRCA1 and BRCA2 gene. Women who carry mutation of those harmful gene have high risk for Breast cancer as well as cervical cancer.

• Age appropriate cancer screening (mammogram above 35 years old , Breast ultrasound under 35 years old and colonoscopy mostly in elderly patient.)

• Pap test and human papillomavirus testing  in-order to reduce cervical cancer incidence.  This test is recommended at the age of 21 and 3 year after first sexual intercourse. 
• CT scan of the chest , abdomen and pelvis in case of increased significant risk
• Pelvic USG and transvaginal USG for female.
• Serum CA125 test used to identify ovarian cancer early and Blood CA 19-9 antigen level increased in patient with pancreatic cancer.