Ann Surg Treat Res.  2017 Dec;93(6):287-292. 10.4174/astr.2017.93.6.287.

Development of second primary cancer in Korean breast cancer survivors

• Jung HK
• Park S
• Kim NW
• Lee JE
• Kim Z
• Han SW
• Hur SM
• Kim SY
• Lim CW
• Lee MH
• Lee J

• KMID: 2396868
• DOI: http://doi.org/10.4174/astr.2017.93.6.287

Abstract

PURPOSE
Breast cancer survivors have slightly increased the risk of second primary cancers. Breast, colon, uterine, and ovarian cancers are common secondary cancers in breast cancer survivors. In this study, we assessed the development of second primary cancers of breast cancer survivors in Korea.
METHODS
Medical records of patients with breast cancer in 3 tertiary medical institutions were reviewed retrospectively. We evaluated secondary malignancy diagnosed at least 2 months after the breast cancer diagnosis. Based on the International Classification of Disease-9 codes of malignancies, secondary primary breast cancer records were evaluated with person-year adjustment. The standardized incidence ratio (SIR) was assessed using national cancer incidence.
RESULTS
A total of 3,444 treatment records were included from 3 medical centers. The cumulative incidence of overall second primary cancers was 2.8% (n = 93). The SIR was significantly higher in all sites (1.56; 95% confidence interval [CI], 1.26-1.91), endometrial cancer (5.65; 95% CI, 2.06-12.31), biliary tract cancer (3.96; 95% CI, 1.19-8.60), and thyroid cancer (2.29; 95% CI, 1.67-3.08).
CONCLUSION
The incidence of cancer was higher in breast cancer survivors compared to general population. Surveillance of secondary cancer in this group should be recommended individually considering the benefit related to the prognosis of primary breast cancer.

Keyword

Breast neoplasms; Neoplasms; Second primary; Survivors; Early detection of cancer

MeSH Terms

Biliary Tract Neoplasms
Breast Neoplasms*
Breast*
Classification
Colon
Diagnosis
Early Detection of Cancer
Endometrial Neoplasms
Female
Humans
Incidence
Korea
Medical Records
Neoplasms, Second Primary*
Ovarian Neoplasms
Prognosis
Retrospective Studies
Survivors*
Thyroid Neoplasms

Figure

• 

  Fig. 1 Description of the study population. A total of 433 patients were excluded in the evaluation.

• 

  Fig. 2 Time to development of second primary cancer. Panel A presents the number of patients who were diagnosed with secondary cancer following the initial diagnosis. The first peak is observed from 1 to 3 years after primary cancer, and the second peak is seen from 7 to 10 years after primary cancer. Panel B shows the time interval of secondary cancers with significant SIR after primary cancer. AML, acute myeloid leukemia.

Reference

1. Oh CM, Won YJ, Jung KW, Kong HJ, Cho H, Lee JK, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2013. Cancer Res Treat. 2016; 48:436–450.

2. National Cancer Center. Annual report of cancer statistics in Korea in 2012. Goyang(Korea): National Cancer Center;2014.

3. Curtis RE, Freedman DM, Ron E, Ries LA, Hacker DG, Edwards BK, editors. New malig nancies among cancer survivors: SEER Cancer Registries, 19732000. National Cancer Institute. NIH Publ. No. 055302. Bethesda (MD): National Cancer Institute;2006.

4. Hulka BS, Brinton LA. Hormones and breast and endometrial cancers: preventive strategies and future research. Environ Health Perspect. 1995; 103:Suppl 8. 185–189.

5. La Vecchia C, Brinton LA, McTiernan A. Cancer risk in menopausal women. Best Pract Res Clin Obstet Gynaecol. 2002; 16:293–307.

6. Brinton LA, Moghissi KS, Scoccia B, Westhoff CL, Lamb EJ. Ovulation induction and cancer risk. Fertil Steril. 2005; 83:261–274.

7. DruesnePecollo N, Touvier M, Barrandon E, Chan DS, Norat T, Zelek L, et al. Excess body weight and second primary cancer risk after breast cancer: a systematic review and meta-analysis of prospective studies. Breast Cancer Res Treat. 2012; 135:647–654.

8. Braithwaite RS, Chlebowski RT, Lau J, George S, Hess R, Col NF. Metaanalysis of vascular and neoplastic events associated with tamoxifen. J Gen Intern Med. 2003; 18:937–947.

9. Yu GP, Schantz SP, Neugut AI, Zhang ZF. Incidences and trends of second cancers in female breast cancer patients: a fixed inception cohort-based analysis (United States). Cancer Causes Control. 2006; 17:411–420.

10. Andersson M, Jensen MB, Engholm G, Henrik Storm H. Risk of second primary cancer among patients with early operable breast cancer registered or randomised in Danish Breast Cancer cooperative Group (DBCG) protocols of the 77, 82 and 89 programmes during 1977-2001. Acta Oncol. 2008; 47:755–764.

11. Mellemkjaer L, Friis S, Olsen JH, Scelo G, Hemminki K, Tracey E, et al. Risk of second cancer among women with breast cancer. Int J Cancer. 2006; 118:2285–2292.

12. Volk N, Pompe-Kirn V. Second primary cancers in breast cancer patients in Slovenia. Cancer Causes Control. 1997; 8:764–770.

13. Tanaka H, Tsukuma H, Koyama H, Kinoshita Y, Kinoshita N, Oshima A. Second primary cancers following breast cancer in the Japanese female population. Jpn J Cancer Res. 2001; 92:1–8.

14. Kim JY, Song HS. Metachronous double primary cancer after treatment of breast cancer. Cancer Res Treat. 2015; 47:64–71.

15. Raymond JS, Hogue CJ. Multiple pri mary tumours in women following breast cancer, 1973-2000. Br J Cancer. 2006; 94:1745–1750.

16. Kamigaki Y, Kawakami K. Risk of second cancer after initial treatment of breast cancer: an Osaka Cancer Registry Database study. Oncol Lett. 2011; 2:963–973.

17. Joseph KR, Edirimanne S, Eslick GD. The association between breast cancer and thyroid cancer: a metaanalysis. Breast Cancer Res Treat. 2015; 152:173–181.

18. Morton LM, Dores GM, Tucker MA, Kim CJ, Onel K, Gilbert ES, et al. Evolving risk of therapyrelated acute myeloid leukemia following cancer chemotherapy among adults in the United States, 1975-2008. Blood. 2013; 121:2996–3004.

19. PetersEngl C, Frank W, Danmayr E, Friedl HP, Leodolter S, Medl M. Association between endometrial cancer and tamoxifen treatment of breast cancer. Breast Cancer Res Treat. 1999; 54:255–260.

20. Fisher B, Costantino JP, Redmond CK, Fisher ER, Wickerham DL, Cronin WM. Endometrial cancer in tamoxifen-treated breast cancer patients: findings from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-14. J Natl Cancer Inst. 1994; 86:527–537.

21. Chlebowski RT, Schottinger JE, Shi J, Chung J, Haque R. Aromatase inhibitors, tamoxifen, and endometrial cancer in breast cancer survivors. Cancer. 2015; 121:2147–2155.

22. Brown LM, Chen BE, Pfeiffer RM, Schairer C, Hall P, Storm H, et al. Risk of second non-hematological malignancies among 376,825 breast cancer survivors. Breast Cancer Res Treat. 2007; 106:439–451.

23. Molina-Montes E, Requena M, Ssnchez-Cantalejo E, Fernandez MF, ArroyoMorales M, Espin J, et al. Risk of second cancers cancer after a first primary breast cancer: a systematic review and meta-analysis. Gynecol Oncol. 2015; 136:158–171.

24. Wilbur J. Surveillance of the adult cancer survivor. Am Fam Physician. 2015; 91:29–36.