机构：[1]Laboratory of Molecular Diagnosis of Cancer, and Department of Medical Oncology, Clinical Research Center for Breast Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.四川大学华西医院[2]Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.[3]Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA.[4]Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.[5]Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.[6]Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.[7]West China Biomedical Big Data Center, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, PR China.四川大学华西医院
Cancer survivors who develop breast cancer as a second malignancy (BCa-2) are common. Yet, little is known about the prognosis of BCa-2 compared to first primary breast cancer (BCa-1).
Using the Surveillance, Epidemiology, and End Results database, we conducted a population-based cohort study including 883,881 patients with BCa-1 and 36,313 patients with BCa-2 during 1990-2015. Compared with patients with BCa-1, we calculated hazard ratios (HRs) of breast cancer-specific mortality among patients with BCa-2, using multivariable Cox regression.
During the follow-up (median 5.5 years), 114,964 and 3829 breast cancer-specific deaths were identified among BCa-1 and BCa-2 patients, respectively. Patients with BCa-2 had more favorable tumor characteristics and received less intensive treatment e.g., surgery and chemo-/radio-therapy, compared to patients with BCa-1. When adjusting for demographic factors, patients with BCa-2 were at similar risk of breast cancer-specific mortality (HR 1.00, 95% CI 0.97-1.03) compared to patients with BCa-1. However, when additionally controlling for tumor characteristics and treatment modes, BCa-2 patients were at an increased risk of breast cancer-specific mortality (HR 1.11, 95% CI 1.08-1.15). The risk elevation was particularly greater when the first malignancy was lung, bladder, ovarian or blood malignancy (HRs 1.16-1.85), or when the first malignancy was treated with chemotherapy and radiotherapy (HR 1.44, 95% CI 1.28-1.63).
Overall, patients with BCa-2 have worse breast cancer-specific survival, compared with their BCa-1 counterparts, although the risk elevation is mild. High-risk subgroups based on first malignancy's characteristics may be considered for active clinical management.
基金：
This study was funded by the National Natural Science Foundation of China
(grant number: 81872307; to Dr. Lu) and Swedish Research Council (grant
number: 2018–00648; to Dr. Lu) and Full-time Postdoc Research and Development Foundation of West China Hospital (grant number: 2019HXBH098; to
Dr. Wang).
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2021]版：
大类|2 区医学
小类|3 区肿瘤学
最新[2023]版：
大类|2 区医学
小类|3 区肿瘤学
第一作者：
第一作者机构：[1]Laboratory of Molecular Diagnosis of Cancer, and Department of Medical Oncology, Clinical Research Center for Breast Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
通讯作者：
通讯机构：[2]Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.[5]Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.[7]West China Biomedical Big Data Center, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, PR China.
推荐引用方式(GB/T 7714)：
Wang Chengshi,Hu Kejia,Deng Lei,et al.Increased risk of breast cancer-specific mortality among cancer survivors who developed breast cancer as a second malignancy.[J].BMC cancer.2021,21(1):491.doi:10.1186/s12885-021-08132-9.
APA：
Wang Chengshi,Hu Kejia,Deng Lei,He Wei,Fang Fang...&Lu Donghao.(2021).Increased risk of breast cancer-specific mortality among cancer survivors who developed breast cancer as a second malignancy..BMC cancer,21,(1)
MLA：
Wang Chengshi,et al."Increased risk of breast cancer-specific mortality among cancer survivors who developed breast cancer as a second malignancy.".BMC cancer 21..1(2021):491
医学