Abstract
Purpose
The aim of this study was to assess the frequency of second primary non-breast cancer after breast cancer diagnosis and treatment, and its correlation with clinicopathological features.
Methods
Data from 21,527 patients with primary breast cancer were collected retrospectively in a single cancer centre; 4.1% of the women developed a second non-breast cancer. The most frequently observed second primary tumor affected the digestive tract (27.8%). The frequency of observed cancers was similar to that expected in the general population, excepting for an excess of melanoma [SIR 1.98 (1.52–2.53)], uterine cancers [SIR 1.44 (1.17–1.74)], ovarian cancers [SIR 1.67 (1.31–2.10)], thyroid tumors [SIR 1.54 (1.23–1.92)], and leukemia [SIR 1.57 (1.11–2.16)].
Results
Clinicopathological breast cancer stratification showed a general increased risk of developing a second cancer in older patients, excluding ovarian cancer. An increased risk of developing ovarian cancer after breast cancer diagnosis was observed, in particular, in triple-negative [HR 3.47 (1.91–6.29)], G3 tumors [HR 2.54 (1.10–5.83)] and in positive breast cancer family history [HR 2.19 (1.22–3.94)]. Breast cancer survivors in hormonal therapy treatment are at higher risk for developing a second thyroid cancer [HR 4.00 (1.46–10.9)]. Conversely, adjuvant chemotherapy offered a protective effect on thyroid cancer risk development [HR 0.46 (0.28–0.76)].
Conclusions
Older age represents the major risk of developing a second primary non-breast cancer, excluding ovarian cancer. Clinical surveillance is required to prevent ovarian and thyroid cancers, respectively, in patients with positive family history, triple negative, G3 breast cancer and during hormonal therapy treatment in postmenopausal status.
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Acknowledgements
We acknowledge William Russell-Edu for his support in editing the draft of this manuscript, and Maria Grazia Villardita for her editorial assistance.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study. The manuscript was approved by the local scientific committee (IEO Research Platform Protocol nr. RB025, 16 Feb 2017).
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Corso, G., Veronesi, P., Santomauro, G.I. et al. Multiple primary non-breast tumors in breast cancer survivors. J Cancer Res Clin Oncol 144, 979–986 (2018). https://doi.org/10.1007/s00432-018-2621-9
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DOI: https://doi.org/10.1007/s00432-018-2621-9