Secondary cancers after breast-conserving therapy in Tokyo database.

Authors

null

Kenshiro Shiraishi

The University of Tokyo Hospital, Tokyo, Japan

Kenshiro Shiraishi , Keiichi Nakagawa , Jiro Kawamori , Kenji Ibukuro , Atsushi Fukuuchi , Tsunehiro Nishi , Tomohiro Shinozaki

Organizations

The University of Tokyo Hospital, Tokyo, Japan, Department of Palliative Medicine, University of Tokyo Hospital, Tokyo, Japan, St. Luke's International Hospital, Tokyo, Japan, Mitsui Memorial Hospital, Tokyo, Japan, Department of Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan, Department of Biostatistics, University of Tokyo, Tokyo, Japan

Research Funding

No funding sources reported

Background: The more patients overcome early breast cancer and become cancer survivors as a result of modern sophisticated approach, the more secondary cancers inevitably arise. The second malignancies after breast conserving therapy (BCT) are well-known sticky dilemma because of additional anxiety and need for medical care for longer-time. However, it is unclear whether secondary cancers negatively affect prognosis of breast cancer survivors. Methods: We performed a retrospective study of long-term cancer survivors after BCT for locoregional invasive or noninvasive breast cancer diagnosed between 1982 and mid-2012. Actuarial rates of overall (OS) and cause-specific survival (CSS) were calculated by using the Kaplan-Meier method. We compared between-group differences using the log-rank test. Results: Eight hundred sixty patients (32%) were followed-up for more than 10 years. At a median follow-up of 90 months, 146 patients had developed a second malignancy. The greatest increases in risk were for leukemia (Standardized incidence ratio (SIR): 4.24 (1.52–8.31)), ovarian cancer (SIR: 4.12 (2.40–6.31)), reno-ureteral cancer (SIR: 3.18 (1.14–6.23)), endometrial cancer (SIR: 2.48 (1.27–4.08)), and pancreatic cancer (SIR: 2.32 (1.11–3.99)). No increased risk was observed for other gastrointestinal and genitourinary cancer, malignant melanoma, lymphoma, thyroid or head and neck cancer. Overall 10-year cumulative incidence of OS without secondary cancer was 93.3%, and 10-year cumulative incidence of OS with secondary cancer was 81.5%. (p<0.001)Overall 10-year cumulative incidence of CSS without secondary cancer was 94.2%, and 10-year cumulative incidence of CSS with secondary cancer was 92.8%. (p=0.749). This likelihood of survival disadvantage is similar to that with ipsilateral breast tumor recurrecnce. Conclusions: Secondary cancers after BCT negatively impact on OS. Given the life-threatening nature to cancer survivors, lifetime caution such as smoking cessation, alcohol intake abstention, weight control, physical activity, and other healthy lifeclass must be paid.

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Abstract Details

Meeting

2013 Breast Cancer Symposium

Session Type

Poster Session

Session Title

General Poster Session B

Track

Survivorship and Health Policy,Systemic Therapy

Sub Track

Survivorship

Citation

J Clin Oncol 31, 2013 (suppl 26; abstr 139)

DOI

10.1200/jco.2013.31.26_suppl.139

Abstract #

139

Poster Bd #

D9

Abstract Disclosures

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