Gynaecological malignancies after breast cancer diagnosis: A population-based study

Abstract

Background: Breast cancer (BC) is one of the most prevalent malignancies. BC survivors have higher risk of second primary cancers than the general population. There is an increased interest in BC survivor management, including the prevention of these second cancers. The aim of this study was to assess the risk of gynaecological malignancy (GM) as second neoplasm among BC patients in our population. Methods: Patients with invasive BC diagnosed from 1980 to 2014 included in the Girona Cancer Registry were included. The incidence of second GM in these patients was compared to those in the general population. Second primary cancer was stated as a tumour diagnosed after 2 months from the BC diagnosis. Standardized incidence ratios (SIR) and absolute excess of risk (AER) were calculated. Results: 9,717 patients were diagnosed with invasive BC during this period, with a median age at diagnosis of 61 years, and a median follow-up of 7.9 years. 117 of them developed a second GM. By tumour type, the only statistically signifi cant higher SIR was observed for corpus uteri cancer (SIR:2.28 95% CI 1.82-2.83; AER:6.43 95% CI 4.13-9.14). After reviewing the histology of the corpus uteri cancer cases, we found that 71.4% were type I (endometrioid adenocarcinoma), 15.5% type II (serous adenocarcinomas and clear cell carcinomas), 10.7% carcinosarcomas, 2.4% sarcomas and there were no unspecifi ed malignant neoplasms. Conclusion: BC survivors have an increased risk of corpus uteri cancer, with an increase in unfavourable histologies compared to the general population. Lifelong primary and secondary prevention interventions should be recommended for these patients.

Ten-Year Probabilities of Death Due to Cancer and Cardiovascular Disease among Breast Cancer Patients Diagnosed in North-Eastern Spain

“…Mortality risk was higher in the BC cohort than in the general population for endometrial and ovarian cancer, a result consistent with our previous studies of the risk of second tumours after BC diagnosis [32]. The BC patients in our cohort who died from endometrial cancer were diagnosed with BC, on average, at 70 years of age (see Supplementary Material Figure S2), older than the BC patients in our cohort who died from BC (close to 60 years of age).…”

“…The BC patients in our cohort who died from endometrial cancer were diagnosed with BC, on average, at 70 years of age (see Supplementary Material Figure S2), older than the BC patients in our cohort who died from BC (close to 60 years of age). Endogenous and exogenous hormones could play a role in this outcome [33], as could potential surveillance bias after the diagnosis of BC or tamoxifen treatment, which is related to the development of endometrial hyperplasia and cancer [32][33][34][35][36][37]. Regarding oestrogen receptor or progesterone status [38], common aetiological factors among BC subtypes might also increase the risk of endometrial cancer [39][40][41][42].…”

Risk of endometrial cancer after RRSO in BRCA 1/2 carriers: a multicentre cohort study

“…Multiple studies have shown an increased risk of endometrial cancer in association with prolonged tamoxifen use. Some authors published an increased risk of aggressive histology of endometrial cancer with poor prognosis in those treated with tamoxifen [ 18 , 25 ] while others have not found this relationship [ 14 , 24 ].…”