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Yuan L, Chen Y, Li X, Jin H, Shi J. Predictive models for overall survival in breast cancer patients with a second primary malignancy: a real-world study in Shanghai, China. BMC Womens Health 2022; 22:498. [PMID: 36474253 PMCID: PMC9724326 DOI: 10.1186/s12905-022-02079-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The incidents of second primary malignancy (SPM) is increasing among breast cancer (BC) patients with long-term progression, adversely affecting survival. The purpose of this study was to screen independent overall survival (OS) risk factors and establish nomograms to predict the survival probabilities of BC patients with SPM. METHOD A total of 163 BC patients with SPM were recruited during 2002-2015 from a total of 50 hospitals in Shanghai, China. Two nomograms to predict survival from primary BC and SPM diagnosis were constructed based on independent factors screened from multivariable analysis. The calibration and discrimination of nomograms were calculated in the training and validation cohorts. RESULTS The overall survival rates of BC patients with SPM were 88.34%, 64.42% and 54.66% at 5, 10 and 15 years, respectively. Factors of late TNM stage of SPM (HR = 4.68, 95% CI 2.14-10.25), surgery for SPM (HR = 0.60, 95% CI 0.36-1.00), SPM in the colon and rectum (HR = 0.49, 95% CI 0.25-0.98) and thyroid (HR = 0.08, 95% CI 0.01-0.61) independently affected the OS of BC patients with SPM (p < 0.05). In addition, a longer latency (≥ 5 years) was associated with better OS from BC diagnosis (p < 0.001). Older age (≥ 56) was associated with poor OS from SPM diagnosis (p = 0.019). Two nomograms established based on the above factors had better calibration and discrimination. CONCLUSION The TNM stage of SPM, surgery for SPM, SPM sites, latency and age at BC diagnosis are independent factors for survival and the two nomograms may provide more personalized management for BC patients with SPM.
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Affiliation(s)
- Ling Yuan
- grid.16821.3c0000 0004 0368 8293School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, 200025 China
| | - Yichen Chen
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136 China ,grid.8547.e0000 0001 0125 2443Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, China
| | - Xiaopan Li
- grid.11841.3d0000 0004 0619 8943Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, 180 Fenglin RD, Shanghai, 200032 China
| | - Hua Jin
- grid.24516.340000000123704535Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue RD, Shanghai, 200090 China ,Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090 China
| | - Jianwei Shi
- grid.24516.340000000123704535Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue RD, Shanghai, 200090 China ,grid.16821.3c0000 0004 0368 8293Department of Social Medicine and Health Management, School of Public Health, Shanghai Jiaotong Universtiy School of Medicine, 227 South Chongqing RD, Shanghai, 200025 China
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Ripamonti CB, Bossi P, Manoukian S, Locati L, Colombo M, Carcangiu ML, Vingiani A, Licitra L, Radice P. Malignant salivary gland tumours in families with breast cancer susceptibility. Virchows Arch 2021; 479:221-226. [PMID: 34100114 DOI: 10.1007/s00428-021-03105-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/26/2021] [Accepted: 04/19/2021] [Indexed: 11/26/2022]
Abstract
Salivary gland cancers (SGCs) are rare malignancies with highly heterogeneous histological features. Patients affected with SGCs are at increased risk of secondary malignancies, including breast cancer (BC). Previous studies enlightened a possible link between SGCs and hereditary predisposition to BC. Here, we searched for SGC-affected patients in 1796 high-risk BC families recruited at the Genetic Unit of the Istituto Nazionale dei Tumori of Milan, 516 of which carried pathogenic variants in BRCA1 and/or BRCA2, the main genetic risk factors for BC. We detected five families with an individual affected with SGC, including two male patients, one carrying a constitutional mutation in BRCA1 and the other in BRCA2. Loss of heterozygosity of BRCA wild-type alleles was assessed in the patients' tumour DNA. We conclude that our observations support the hypothesis that genetic factors associated with BC susceptibility might play a role also in at least a subset of SGCs.
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Affiliation(s)
- Carla B Ripamonti
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Research Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Amadeo 42, 20133, Milan, Italy.
| | - Paolo Bossi
- Unit of Head and Neck Cancers, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology Fondazione, IRCCS Istituto Nazionale Dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Laura Locati
- Unit of Head and Neck Cancers, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Mara Colombo
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Research Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Amadeo 42, 20133, Milan, Italy
| | - Maria L Carcangiu
- Unit of Anatomic Pathology 1, Department of Pathology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Andrea Vingiani
- Unit of Anatomic Pathology 2, Department of Pathology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Lisa Licitra
- Unit of Head and Neck Cancers, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Venezian 1, 20133, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Research Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Amadeo 42, 20133, Milan, Italy
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Valstar MH, Schaapveld M, van den Broek EC, van Velthuysen MLF, de Ridder M, Schmidt MK, van Dijk BAC, Balm AJM, Smeele LE. Risk of breast cancer in women after a salivary gland carcinoma or pleomorphic adenoma in the Netherlands. Cancer Med 2020; 10:424-434. [PMID: 33247629 PMCID: PMC7826476 DOI: 10.1002/cam4.3598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 09/25/2020] [Accepted: 10/17/2020] [Indexed: 11/25/2022] Open
Abstract
Salivary and mammary gland tumors show morphological similarities and share various characteristics, including frequent overexpression of hormone receptors and female preponderance. Although this may suggest a common etiology, it remains unclear whether patients with a salivary gland tumor carry an increased risk of breast cancer (BC). Our purpose was to determine the risk of BC in women diagnosed with salivary gland carcinoma (SGC) or pleomorphic adenoma (SGPA). BC incidence (invasive and in situ) was assessed in two nationwide cohorts: one comprising 1567 women diagnosed with SGC and one with 2083 women with SGPA. BC incidence was compared with general population rates using standardized incidence ratio (SIR). BC risk was assessed according to age at SGC/SGPA diagnosis, follow‐up time and (for SGC patients) histological subtype. The mean follow‐up was 7.0 years after SGC and 9.9 after SGPA diagnosis. During follow‐up, 52 patients with SGC and 74 patients with SGPA developed BC. The median time to BC was 6 years after SGC and 7 after SGPA. The cumulative risk at 10 years of follow‐up was 3.1% after SGC and 3.5% after SGPA (95% Confidence Interval (95%CI) 2.1%–4.7% and 2.6%–4.6%, respectively). BC incidence was 1.59 times (95%CI 1.19–2.09) higher in the SGC‐cohort than expected based on incidence rates in the general population. SGPA‐patients showed a 1.48 times (95%CI 1.16–1.86) higher incidence. Women with SGC or SGPA have a slightly increased risk of BC. The magnitude of risk justifies raising awareness, but is no reason for BC screening.
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Affiliation(s)
- Matthijs H Valstar
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael Schaapveld
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Esther C van den Broek
- The Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA, Houten, The Netherlands
| | | | - Mischa de Ridder
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands.,Department of Radiation Oncology, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands
| | - Marjanka K Schmidt
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands.,Division of Molecular Pathology, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Boukje A C van Dijk
- Netherlands Comprehensive Cancer Organization (IKNL, Department of Research and Development, Utrecht, The Netherlands.,Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Alfons J M Balm
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ludi E Smeele
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Ozdemir Y, Topkan E. Second primary malignancies in laryngeal carcinoma patients treated with definitive radiotherapy. Indian J Cancer 2019; 56:29-34. [PMID: 30950440 DOI: 10.4103/ijc.ijc_273_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Second primary malignancy (SPM) is associated with decreased overall survival (OS) in laryngeal carcinomas (LC). METHODS One hundred eighty three LC patients were analyzed retrospectively. The primary and secondary endpoints were the incidence of SPM and the OS difference between patients with and without SPM. RESULTS SPM developed in 22 (12.0%) patients at median 52 months (range, 4-131 months), with a yearly 2.8% incidence, of which 19 (10.4%) and 3 (1.6%) were metachronous and synchronous, respectively. Lung was the commonest SPM (72.7%). Of 47 deaths, 12 (25.5%) were SPM related. Comparatively SPM patients had significantly shorter median OS (68.0 months vs. median not reached; P = 0.005), with lower 5-year (67.0% vs. 78.9%) and 8-year (32.6 vs. 69.8%) survival rates. CONCLUSION The present findings suggested the SPM as a competing risk factor for death in index LC patients with its annual incidence rate of 2.8% and for accounting one of every four deaths in this patients group. Emergence of lung carcinoma as the most frequent type of SPM and the ability to treat >50% of them with an estimated long-term outcomes emphasizes the importance of early diagnosis and curative treatment of SPMs.
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Affiliation(s)
- Yurday Ozdemir
- Department of Radiation Oncology, Baskent University Adana Treatment and Research Center, Adana, Turkey
| | - Erkan Topkan
- Department of Radiation Oncology, Baskent University Adana Treatment and Research Center, Adana, Turkey
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Survival and chemotherapy-related risk of second primary malignancy in breast cancer patients: a SEER-based study. Int J Clin Oncol 2019; 24:934-940. [PMID: 30888527 DOI: 10.1007/s10147-019-01430-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/14/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND With the improvement in the survival of breast cancer, developing second primary malignancy becomes a serious health issue. The aim of this study was to explore the survival of breast cancer patients with second primary malignancy, and to evaluate the impact of chemotherapy on the risk of different cancer sites. METHOD Obtaining data from the Surveillance, Epidemiology, and End Results database, we calculated the standardized incidence ratio (SIR) for second primary malignancy in breast cancer survivors between 2000 and 2014. Overall survival and cancer-specific survival were analyzed with Kaplan-Meier method. Then, we further conducted stratified sub-analyses according to chemotherapy. RESULTS The overall risk of second primary cancer for all sites was significantly elevated in breast cancer patients (SIR = 1.15, 95% CI 1.14-1.16). Overall survival and cancer-specific survival of the patients with breast cancer only were significantly better than the patients with multiple primary cancers (both P < 0.001). Chemotherapy was associated with increased incidences for all sites, except lymphoma, myeloma, and chronic lymphocytic leukemia (SIR = 0.80, 95% CI 0.72-0.88; SIR = 0.85, 95% CI 0.71-1.01; SIR = 0.57, 95% CI 0.43-0.74, respectively). The risk for developing second acute myeloid leukemia after chemotherapy in breast cancer patients varied with age and latency. CONCLUSION Female breast cancer patients showed higher incidence of second primary malignancy, which was associated with poorer prognosis. Chemotherapy benefits should be weighed against the risks of second primary malignancy.
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