Risk of New Primary Nonbreast Cancers After Breast Cancer Treatment: A Dutch Population-Based Study

Schaapveld, Michael; Visser, Otto; Louwman, Marieke W. J.; Vries, Elisabeth G.E. de; Willemse, Pax H.B.; Otter, Renée; Graaf, Winette T.A. van der; Coebergh, Jan Willem; Leeuwen, Flora E. van

doi:10.1200/jco.2007.11.9081

Cited by 188 publications

(200 citation statements)

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“…Our site-specific results were broadly similar to those from a pooled analysis of 63 randomised clinical trials of breast cancer radiotherapy and several observational studies. In these studies, there was evidence of increased risks of lung (Zablotska and Neugut, 2003;Roychoudhuri et al, 2004;Clarke et al, 2005;Darby et al, 2005;Andersson et al, 2008;Schaapveld et al, 2008), oesophageal (Zablotska and Neugut, 2003;Roychoudhuri et al, 2004;Clarke et al, 2005) and contralateral breast cancer (Gao et al, 2003;Roychoudhuri et al, 2004;Clarke et al, 2005), as well as soft tissue sarcomas (Huang and Mackillop, 2001;Clarke et al, 2005;Andersson et al, 2008), in women treated with radiotherapy compared with unirradiated women. In the pooled analysis of clinical trials , the authors did not estimate attributable risks, but it was possible to estimate them on the basis of the data presented.…”

Section: Discussionmentioning

confidence: 99%

Second solid cancers after radiotherapy for breast cancer in SEER cancer registries

et al. 2009

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BACKGROUND: Radiotherapy for breast cancer reduces disease recurrence and breast cancer mortality. However, it has also been associated with increased second cancer risks in exposed sites. METHODS: We evaluated long-term second cancer risks among 182 057 5-year survivors of locoregional invasive breast cancer diagnosed between 1973 and 2000 and reported to US NCI-SEER Program cancer registries. Multivariate Poisson regression was used to estimate the relative risk (RR) and excess cases of second cancer in women who had surgery and radiotherapy, compared with those who had surgery alone. Second cancer sites were grouped according to doses received from typical tangential breast fields. RESULTS: By the end of 2005 (median follow-up ¼ 13.0 years), 15 498 second solid cancers had occurred, including 6491 contralateral breast cancers. The RRs for radiotherapy were 1.45 (95% confidence interval (CI) ¼ 1.33 -1.58) for high-dose second cancer sites (1 þ Gy: lung, oesophagus, pleura, bone and soft tissue) and 1.09 (1.04 -1.15) for contralateral breast cancer (E1 Gy). These risks decreased with increasing age and year of treatment. There was no evidence of elevated risks for sites receiving medium (0.5 -0.99 Gy, RR ¼ 0.89 (0.74 -1.06)) or low doses (o0.5 Gy, RR ¼ 1.01 (0.95 -1.07)). The estimated excess cases of cancer in women treated with radiotherapy were as follows: 176 (95% CI ¼ 69 -284) contralateral breast cancers or 5% (2 -8%) of the total in all 1 þ year survivors, and 292 (222 -362) other solid cancers or 6% (4 -7%) of the total. CONCLUSIONS: Most second solid cancers in breast cancer survivors are not related to radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Second solid cancers after radiotherapy for breast cancer in SEER cancer registries

et al. 2009

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“…Most of those studies addressing melanoma risk after breast cancer concerned patients treated in the distant past and therefore with treatment regimens not including hormonal therapy (15,16), or lacked antiestrogen data or when available, did not evaluate if hormonal therapy influenced melanoma risk (17,19,(20)(21)(22)24). To our knowledge, only 2 prior studies evaluated melanoma cancer risk among breast cancer patients according to hormonal therapy (23,24). The large study from the Netherlands of a population-based breast cancer cohort (23) showed an increased risk of secondary melanoma (SIR: 1.69, 95% CI: 1.44-1.97).…”

Section: Discussionmentioning

confidence: 96%

“…To our knowledge, only 2 prior studies evaluated melanoma cancer risk among breast cancer patients according to hormonal therapy (23,24). The large study from the Netherlands of a population-based breast cancer cohort (23) showed an increased risk of secondary melanoma (SIR: 1.69, 95% CI: 1.44-1.97). As in our study, the excess was absent in women with hormonal therapy.…”

Section: Discussionmentioning

confidence: 99%

Antiestrogen Therapy for Breast Cancer Modifies the Risk of Subsequent Cutaneous Melanoma

Huber

Schaffar

Neyroud-Caspar

et al. 2012

Cancer Prevention Research

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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 (SIR: 1.60, 95% CI: 1.08-2.12, P ¼ 0.02). On the contrary, the risk was close to 1 (SIR: 0.98, 95% CI: 0.40-1.56, P ¼ 0.57) for patients who received antiestrogen therapy. This study suggests that antiestrogen therapy modifies the risk of melanoma after breast cancer. Although our results are in agreement with the hypothesis that estrogens could play a role in melanoma occurrence, they need to be replicated in a larger study with data on potential confounders. Cancer Prev Res; 5(1); 82-88. Ó2012 AACR.

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“…The incidence rate ratios (IRR) between the treatment and corresponding non-treated group were then compared. In these calculations, patients were considered to be at risk from the date of diagnosis of the primary breast cancer until the date of diagnosis of the respective second cancer, date of death, last date on which the patient was known to be alive, or end of the study period (December 31,2003), whichever criterion occurred first. The effects of treatment on the second cancer were adjusted for covariates and analyzed with stratification by age at the first primary breast cancer, time since diagnosis of the first primary breast cancer, and type of combined treatment.…”

Section: Methodsmentioning

confidence: 99%

Risk of second cancer after initial treatment of breast cancer: An Osaka Cancer Registry Database study

Kamigaki

Kawakami

2011

Oncol Lett

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Abstract. In the present study, the association between the incidence of second cancer and initial treatment for primary breast cancer was investigated using the Osaka Cancer Registry in Japan. We selected 45,575 patients diagnosed with breast cancer between January 1975 and December 2003. Information on initial cancer treatment and second cancer was obtained from the Osaka Cancer Registry. Patients were classified according to initial treatment (chemo-, hormone, or radiotherapy, or no treatment). We calculated the incidence rate ratio of second cancers in patients classified by treatment for the first cancer. The effects of treatment adjusted for covariates on second cancers were examined using stratified analyses and a Cox proportional hazard model. The final number of 33,043 subjects had a mean duration of follow-up of 5.2±4.3 years, during which 1,857 second cancers were diagnosed. For hormone therapy, the incidence rate ratio (IRR) of all second cancers was 0.64 [95% confidence interval (CI), 0.58-0.70], and that of corpus uteri cancer was 3.04 (95% CI, 1. 78-5.19). The multivariate analysis revealed that the IRR of corpus uteri cancer associated with hormone therapy was 2.53 (95% CI, 1.41-4.55). The incidence rate of all second cancers associated with initial treatment was lower than that associated with no treatment. Only second corpus uteri cancer may be related to hormone therapy.

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Risk of New Primary Nonbreast Cancers After Breast Cancer Treatment: A Dutch Population-Based Study

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

Cited by 188 publications

References 44 publications

Second solid cancers after radiotherapy for breast cancer in SEER cancer registries

Second solid cancers after radiotherapy for breast cancer in SEER cancer registries

Antiestrogen Therapy for Breast Cancer Modifies the Risk of Subsequent Cutaneous Melanoma

Risk of second cancer after initial treatment of breast cancer: An Osaka Cancer Registry Database study

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