Breast cancer in the 17th century: the two wives of Luis Guillermo de Moncada

The mummified and skeletonized remains of nobles buried in the Neapolitan Basilica of San Domenico Maggiore (15th-17th century) constitute an important series with regard to paleo-oncology, since three of the five cases of soft tissue tumors known in paleopathology worldwide are documented in this Italian series. In this study, we focused our attention on the new cases of cancer of the princesses Moncada: Maria Afán de Ribera (ca. 1615-1639) and Catalina Moncada de Castro (1611-1659). The study was performed by macroscopic and radiological analysis of osteological remains of the two noblewomen and by the investigation on 17th century archival sources in order to obtain an accurate retrospective diagnosis. The radiological documentation allowed to detect some focal neoplastic osteolytic lesions in the skeletal remains of the two noblewomen. These lesions supported a diagnosis of metastatic carcinoma, but the historical and archival sources were fundamental to diagnose breast cancer in both individuals. The two new cases of breast cancer must be added to the three malignant tumours previously known from the aristocratic series of San Domenico Maggiore in Naples (15th-17th century). Therefore, out of a total of eighteen adult individuals, five (28%) were affected by cancer. Despite the small sample size, this prevalence is surprisingly comparable to that of the contemporary Western world.