Second malignancies after breast cancer: the impact of different treatment modalities
Open Access
- 12 February 2008
- journal article
- research article
- Published by Springer Science and Business Media LLC in British Journal of Cancer
- Vol. 98 (5), 870-874
- https://doi.org/10.1038/sj.bjc.6604241
Abstract
Treatment for non-metastatic breast cancer (BC) may be the cause of second malignancies in long-term survivors. Our aim was to investigate whether survivors present a higher risk of malignancy than the general population according to treatment received. We analysed data for 16 705 BC survivors treated at the Curie Institute (1981–1997) by either chemotherapy (various regimens), radiotherapy (high-energy photons from a 60Co unit or linear accelerator) and/or hormone therapy (2–5 years of tamoxifen). We calculated age-standardized incidence ratios (SIRs) for each malignancy, using data for the general French population from five regional registries. At a median follow-up 10.5 years, 709 patients had developed a second malignancy. The greatest increases in risk were for leukaemia (SIR: 2.07 (1.52–2.75)), ovarian cancer (SIR: 1.6 (1.27–2.04)) and gynaecological (cervical/endometrial) cancer (SIR: 1.6 (1.34–1.89); PP<0.007). The increase in leukaemia was most strongly related to chemotherapy and that in gynaecological cancers to hormone therapy. Radiotherapy alone also had a significant, although lesser, effect on leukaemia and gynaecological cancer incidence. The increased risk of sarcomas and lung cancer was attributed to radiotherapy. No increased risk was observed for malignant melanoma, lymphoma, genitourinary, thyroid or head and neck cancer. There is a significantly increased risk of several kinds of second malignancy in women treated for BC, compared with the general population. This increase may be related to adjuvant treatment in some cases. However, the absolute risk is small.Keywords
This publication has 53 references indexed in Scilit:
- Prophylactic salpingo‐oophorectomy in a series of 89 women carrying a BRCA1 or a BRCA2 mutationCancer, 2007
- Risk of Second Malignancies After Adjuvant Radiotherapy for Breast Cancer: A Large-Scale, Single-Institution ReviewInternational Journal of Radiation Oncology*Biology*Physics, 2007
- Risk of breast cancer recurrence and contralateral breast cancer in relation to BRCA1 and BRCA2 mutation status following breast-conserving surgery and radiotherapyEuropean Journal Of Cancer, 2005
- Radiation‐induced sarcomas after radiotherapy for breast carcinomaCancer, 2005
- Soft tissue sarcoma after treatment for breast cancer—A Swedish population-based studyEuropean Journal Of Cancer, 1998
- Should prophylactic surgery be used in women with a high risk of breast cancer?: Pro:European Journal Of Cancer, 1997
- Quantum leaps in treatment of high-risk breast cancer? Prove it!European Journal Of Cancer, 1993
- Second primary neoplasms following breast cancer in Saarland, Germany, 1968–1987European Journal Of Cancer, 1993
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958