Ann Surg Treat Res.  2023 Jul;105(1):1-9. 10.4174/astr.2023.105.1.1.

Survival analysis of breast cancer patients after diagnosis of second primary malignancies, focusing on the second primary hematologic malignancy

• Kim HJ
• Lee J
• Park IC
• Han Y
• Seong MK
• Noh WC
• Kang HJ
• Kim HA
• Park CS

• KMID: 2544597
• DOI: http://doi.org/10.4174/astr.2023.105.1.1

Abstract

Purpose
Although the overall survival (OS) of breast cancer patients is increasing with improved detection and therapies, so is the risk of breast cancer patients developing subsequent malignancies. We investigated the OS of breast cancer survivors according to sites of second primary malignancies (SPM). The OS of the second primary hematologic malignancy (SPHM) was then compared with that of metastatic breast cancer (MBC).
Methods
We retrospectively analyzed patients diagnosed with primary breast cancer between 1998 and 2019. Only those with SPM were eligible for analysis. First, the OS of patients with SPM diagnosed as the first event after the diagnosis of breast cancer was analyzed. Next, the OS of patients with SPHM, with or without breast cancer relapse, was compared with that of patients with MBC, matched using the propensity score.
Results
Patients diagnosed with SPM without breast cancer relapse as the first event had a significantly better OS than did patients with MBC, but the OS of those with SPHM as the first event did not differ significantly from that of patients with MBC (hazard ratio [HR], 1.558; 95% confidence interval [CI], 0.856–2.839; P = 0.147). The OS of patients with SPHM with or without breast cancer relapse was worse than that of the MBC group after propensity score matching (HR, 1.954; 95% CI, 1.045–3.654; P = 0.036).
Conclusion
Prognosis of SPM diagnosed as the first event was statistically better than that of MBC, except in case of SPHM. Patients with SPHM, with or without MBC, showed poor OS before and after propensity score matching.

Keyword

Breast neoplasms; Hematologic malignancy; Second primary neoplasms; Survival analysis

Figure

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  Fig. 1 Description of the study analysis. SPM, second primary malignancy; SPHM, second privary hematologic malignancy; MBC, metastatic breast cancer.

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  Fig. 2 Overall survival of metastatic breast cancer vs. the second primary malignancy diagnosed as the first event.

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  Fig. 3 Overall survival of all second primary hematologic malignancies and metastatic breast cancer before (A) and after (B) propensity score matching.

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