Advanced

Risk of second primary malignancies in women with breast cancer: Results from the European prospective investigation into cancer and nutrition (EPIC)

Ricceri, Fulvio; Fasanelli, Francesca; Giraudo, Maria Teresa; Sieri, Sabina; Tumino, Rosario; Mattiello, Amalia; Vagliano, Liliana; Masala, Giovanna; Ramon Quiros, J. and Travier, Noemie, et al. (2015) In International Journal of Cancer 137(4). p.940-948
Abstract
Women with a diagnosis of breast cancer are at increased risk of second primary cancers, and the identification of risk factors for the latter may have clinical implications. We have followed-up for 11 years 10,045 women with invasive breast cancer from a European cohort, and identified 492 second primary cancers, including 140 contralateral breast cancers. Expected and observed cases and Standardized Incidence Ratios (SIR) were estimated using Aalen-Johansen Markovian methods. Information on various risk factors was obtained from detailed questionnaires and anthropometric measurements. Cox proportional hazards regression models were used to estimate the role of risk factors. Women with breast cancer had a 30% excess risk for second... (More)
Women with a diagnosis of breast cancer are at increased risk of second primary cancers, and the identification of risk factors for the latter may have clinical implications. We have followed-up for 11 years 10,045 women with invasive breast cancer from a European cohort, and identified 492 second primary cancers, including 140 contralateral breast cancers. Expected and observed cases and Standardized Incidence Ratios (SIR) were estimated using Aalen-Johansen Markovian methods. Information on various risk factors was obtained from detailed questionnaires and anthropometric measurements. Cox proportional hazards regression models were used to estimate the role of risk factors. Women with breast cancer had a 30% excess risk for second malignancies (95% confidence interval-CI 18-42) after excluding contralateral breast cancers. Risk was particularly elevated for colorectal cancer (SIR, 1.71, 95% CI 1.43-2.00), lymphoma (SIR 1.80, 95% CI 1.31-2.40), melanoma (2.12; 1.63-2.70), endometrium (2.18; 1.75-2.70) and kidney cancers (2.40; 1.57-3.52). Risk of second malignancies was positively associated with age at first cancer, body mass index and smoking status, while it was inversely associated with education, post-menopausal status and a history of full-term pregnancy. We describe in a large cohort of women with breast cancer a 30% excess of second primaries. Among risk factors for breast cancer, a history of full-term pregnancy was inversely associated with the risk of second primary cancer. What's new? For the first time, researchers have used cohort data to show that people who survive breast cancer have a higher risk of developing another cancer later. By collecting data on 10,000 breast cancer patients over 11 years, these authors calculated a 30% boost in the patients' risk of developing a second primary malignancy, particularly colorectal cancer, lymphoma, melanoma, endometrial cancer, and kidney cancer. These findings, plus the data they collected on risk factors such as age, smoking, body mass index, and others, will help guide clinicians in screening procedures and follow up care for breast cancer patients. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
second primary tumours, breast cancer, Aalen-Johansen estimator, tumour, size
in
International Journal of Cancer
volume
137
issue
4
pages
940 - 948
publisher
John Wiley & Sons
external identifiers
  • wos:000356428400020
  • scopus:84931567340
ISSN
0020-7136
DOI
10.1002/ijc.29462
language
English
LU publication?
yes
id
a36fecd5-2dd2-4b31-a21b-abe30f673070 (old id 7596650)
date added to LUP
2015-08-03 10:09:31
date last changed
2017-09-03 03:05:00
@article{a36fecd5-2dd2-4b31-a21b-abe30f673070,
  abstract     = {Women with a diagnosis of breast cancer are at increased risk of second primary cancers, and the identification of risk factors for the latter may have clinical implications. We have followed-up for 11 years 10,045 women with invasive breast cancer from a European cohort, and identified 492 second primary cancers, including 140 contralateral breast cancers. Expected and observed cases and Standardized Incidence Ratios (SIR) were estimated using Aalen-Johansen Markovian methods. Information on various risk factors was obtained from detailed questionnaires and anthropometric measurements. Cox proportional hazards regression models were used to estimate the role of risk factors. Women with breast cancer had a 30% excess risk for second malignancies (95% confidence interval-CI 18-42) after excluding contralateral breast cancers. Risk was particularly elevated for colorectal cancer (SIR, 1.71, 95% CI 1.43-2.00), lymphoma (SIR 1.80, 95% CI 1.31-2.40), melanoma (2.12; 1.63-2.70), endometrium (2.18; 1.75-2.70) and kidney cancers (2.40; 1.57-3.52). Risk of second malignancies was positively associated with age at first cancer, body mass index and smoking status, while it was inversely associated with education, post-menopausal status and a history of full-term pregnancy. We describe in a large cohort of women with breast cancer a 30% excess of second primaries. Among risk factors for breast cancer, a history of full-term pregnancy was inversely associated with the risk of second primary cancer. What's new? For the first time, researchers have used cohort data to show that people who survive breast cancer have a higher risk of developing another cancer later. By collecting data on 10,000 breast cancer patients over 11 years, these authors calculated a 30% boost in the patients' risk of developing a second primary malignancy, particularly colorectal cancer, lymphoma, melanoma, endometrial cancer, and kidney cancer. These findings, plus the data they collected on risk factors such as age, smoking, body mass index, and others, will help guide clinicians in screening procedures and follow up care for breast cancer patients.},
  author       = {Ricceri, Fulvio and Fasanelli, Francesca and Giraudo, Maria Teresa and Sieri, Sabina and Tumino, Rosario and Mattiello, Amalia and Vagliano, Liliana and Masala, Giovanna and Ramon Quiros, J. and Travier, Noemie and Sanchez, Maria-Jose and Larranaga, Nerea and Chirlaque, Maria-Dolores and Ardanaz, Eva and Tjonneland, Anne and Olsen, Anja and Overvad, Kim and Chang-Claude, Jenny and Kaaks, Rudolf and Boeing, Heiner and Clavel-Chapelon, Franc Oise and Kvaskoff, Marina and Dossus, Laure and Trichopoulou, Antonia and Benetou, Vassiliki and Adarakis, George and Bueno-de-Mesquita, H. B(As) and Peeters, Petra H. and Sund, Malin and Andersson, Anne and Borgquist, Signe and Butt, Salma and Weiderpass, Elisabete and Skeie, Guri and Khaw, Kay-Tee and Travis, Ruth C. and Rinaldi, Sabina and Romieu, Isabelle and Gunter, Marc and Kadi, Mai and Riboli, Elio and Vineis, Paolo and Sacerdote, Carlotta},
  issn         = {0020-7136},
  keyword      = {second primary tumours,breast cancer,Aalen-Johansen estimator,tumour,size},
  language     = {eng},
  number       = {4},
  pages        = {940--948},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {Risk of second primary malignancies in women with breast cancer: Results from the European prospective investigation into cancer and nutrition (EPIC)},
  url          = {http://dx.doi.org/10.1002/ijc.29462},
  volume       = {137},
  year         = {2015},
}