Metachronous Double Primary Cancer after Treatment of Breast Cancer
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Purpose The pattern of double primary cancer after treatment for breast cancer is important forpatient survival. Materials and MethodsWe analyzed 108 cases of metachronous double primary cancer in breast cancer patientstreated from 1999 to 2012. ResultsMetachronous double primary cancers occurred in 108 of 2,657 patients (4.1%) with breastcancer. The median time to the occurrence of second cancer after diagnosis of the first was58.4±41.2 months (range, 6.9 to 180.2 months). The most common cancer was thyroidcancer, which occurred in 45 patients (41.7%). This was followed by gastric cancer in 16patients (14.8%), endometrial cancer in 10 patients (9.3%), and cervical cancer in sevenpatients (6.5%). The relative risk showed a significant increase in endometrial (4.78; 95%confidence interval [CI], 1.66 to 13.79), gastric (2.61; 95% CI, 1.68 to 4.06), and thyroidcancer (1.95; 95% CI, 1.37 to 2.79). At 5 years after diagnosis of breast cancer, secondarycancer occurred in 48 patients (44.4%), with 50.0% of the endometrial, 56.3% of the stomach,and 37.8% of the thyroid cancer cases being diagnosed after 5 years. Median survivalafter diagnosis of the second cancer was 123.9±11.2 months. The prognosis was mainlyinfluenced by the anatomic site. ConclusionThe incidence of endometrial, stomach, and thyroid cancer increased significantly aftertreatment with primary breast cancer, and survival was dependent on early detection andthe type of second primary cancer. A prolonged follow-up examination for metachronousdouble primary cancer is needed to provide early detection and improve survival time inpatients with breast cancer.
Abstract
Purpose The pattern of double primary cancer after treatment for breast cancer is important forpatient survival. Materials and MethodsWe analyzed 108 cases of metachronous double primary cancer in breast cancer patientstreated from 1999 to 2012. ResultsMetachronous double primary cancers occurred in 108 of 2,657 patients (4.1%) with breastcancer. The median time to the occurrence of second cancer after diagnosis of the first was58.4±41.2 months (range, 6.9 to 180.2 months). The most common cancer was thyroidcancer, which occurred in 45 patients (41.7%). This was followed by gastric cancer in 16patients (14.8%), endometrial cancer in 10 patients (9.3%), and cervical cancer in sevenpatients (6.5%). The relative risk showed a significant increase in endometrial (4.78; 95%confidence interval [CI], 1.66 to 13.79), gastric (2.61; 95% CI, 1.68 to 4.06), and thyroidcancer (1.95; 95% CI, 1.37 to 2.79). At 5 years after diagnosis of breast cancer, secondarycancer occurred in 48 patients (44.4%), with 50.0% of the endometrial, 56.3% of the stomach,and 37.8% of the thyroid cancer cases being diagnosed after 5 years. Median survivalafter diagnosis of the second cancer was 123.9±11.2 months. The prognosis was mainlyinfluenced by the anatomic site. ConclusionThe incidence of endometrial, stomach, and thyroid cancer increased significantly aftertreatment with primary breast cancer, and survival was dependent on early detection andthe type of second primary cancer. A prolonged follow-up examination for metachronousdouble primary cancer is needed to provide early detection and improve survival time inpatients with breast cancer.
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