Incidence of metachronous contralateral breast cancer in Denmark 1978–2009

Rasmussen, Christina B.; Kjær, Susanne K.; Ejlertsen, Bent; Andersson, Michael; Jensen, Maj-Britt; Christensen, Jane; Langballe, Rikke; Mellemkjær, Lene

doi:10.1093/ije/dyu202

Cited by 31 publications

(35 citation statements)

References 35 publications

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“…Rasmussen et al . reported 10‐year cumulative metachronous CBC risks of approximately 4–5.5% in a large population based sample of over 85.000 women with previous invasive BC without distant metastases in Denmark . A population‐based study performed in Switzerland revealed a CBC incidence rate of approximately 4.5–5 per 1,000 PY after 4–11 years follow‐up, compared to 4.1 per 1.000 PY in our study after 5–10 years follow‐up .…”

Section: Discussioncontrasting

confidence: 63%

Breast cancer risk in BRCA1/2 mutation carriers and noncarriers under prospective intensified surveillance

Engel

Fischer

Zachariae

et al. 2019

Intl Journal of Cancer

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Comparably little is known about breast cancer (BC) risks in women from families tested negative for BRCA1/2 mutations despite an indicative family history, as opposed to BRCA1/2 mutation carriers. We determined the age‐dependent risks of first and contralateral breast cancer (FBC, CBC) both in noncarriers and carriers of BRCA1/2 mutations, who participated in an intensified breast imaging surveillance program. The study was conducted between January 1, 2005, and September 30, 2017, at 12 university centers of the German Consortium for Hereditary Breast and Ovarian Cancer. Two cohorts were prospectively followed up for incident FBC (n = 4,380; 16,398 person‐years [PY], median baseline age: 39 years) and CBC (n = 2,993; 10,090 PY, median baseline age: 42 years). Cumulative FBC risk at age 60 was 61.8% (95% CI 52.8–70.9%) for BRCA1 mutation carriers, 43.2% (95% CI 32.1–56.3%) for BRCA2 mutation carriers and 15.7% (95% CI 11.9–20.4%) for noncarriers. FBC risks were significantly higher than in the general population, with incidence rate ratios of 23.9 (95% CI 18.9–29.8) for BRCA1 mutation carriers, 13.5 (95% CI 9.2–19.1) for BRCA2 mutation carriers and 4.9 (95% CI 3.8–6.3) for BRCA1/2 noncarriers. Cumulative CBC risk 10 years after FBC was 25.1% (95% CI 19.6–31.9%) for BRCA1 mutation carriers, 6.6% (95% CI 3.4–12.5%) for BRCA2 mutation carriers and 3.6% (95% CI 2.2–5.7%) for noncarriers. CBC risk in noncarriers was similar to women with unilateral BC from the general population. Further studies are needed to confirm whether less intensified surveillance is justified in women from BRCA1/2 negative families with elevated risk.

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Section: Discussioncontrasting

confidence: 63%

Breast cancer risk in BRCA1/2 mutation carriers and noncarriers under prospective intensified surveillance

Engel

Fischer

Zachariae

et al. 2019

Intl Journal of Cancer

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“…The Danish study referred to above exhibited an increasing incidence in younger patients with a peak 2-4 years after diagnosis, but when adjusted for age and calendar period, incidence rates where more or less constant over time (Rasmussen et al 2014). We are not able to investigate the influence of age on the time to incidence of CBC, as our number of cases is too small for examining incidence rates for certain age groups with regard to follow-up.…”

Section: Discussionmentioning

confidence: 95%

“…Young women might still have an increasing risk of developing a malignant tumour of the breast compared to a declining incidence in general and are probably more likely to develop CBC. A recently published paper with data from the Danish Cancer Registry examined the influence of the longer follow-up of younger patients on the incidence of CBC and also still found a decreasing incidence of CBC with age when limiting the follow-up time (Rasmussen et al 2014). …”

Section: Discussionmentioning

confidence: 99%

Incidence of metachronous contralateral breast cancer in the Canton of Zurich: a population-based study of the cancer registry

Prater¹,

Valeri

Korol³

et al. 2015

J Cancer Res Clin Oncol

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PURPOSE To examine the incidence and characteristics of metachronous contralateral breast cancer (CBC) among women in the Canton of Zurich, Switzerland. METHODS For 1980-2006 with unilateral invasive breast cancer (UBC) were analysed for metachronous CBC. Poisson's regression was used to estimate incidence rates of metachronous CBC according to age, year of diagnosis, follow-up period since first breast cancer and morphology. RESULTS Of 16,323 patients with UBC, 700 (4.3 %) developed a second malignant tumour of the opposite breast. Median age at first breast cancer was lower in the CBC group than in the full cohort. Median interval time between first and second breast cancer was 5.5 (interquartile range 2.6-10.1) years. Incidence rate at age 20-29 was 1006 (95 % confidence interval, CI, 452-2238) cases per 100,000 person-years and decreased to 299 (199-450) at 80-84. Age-adjusted incidence rates according to period of diagnosis decreased from 618 (530-721) for 1980-1984 to 329 (217-500) cases per 100,000 person-years for [2005][2006]. Incidence rate ratio of CBC for lobular carcinoma was 1.28 (95 % CI 0.99-1.67) adjusted by age group and period of diagnosis compared to ductal carcinoma. CONCLUSIONS In our study, incidence rates for CBC are comparable with findings from the literature. A reduction in the incidence of metachronous CBC, thought to be due to adjuvant therapies, is seen in our data. In our cohort, younger age and lobular carcinoma were associated with an increased risk of CBC. Incidence rate ratio of CBC for lobular carcinoma was 1.28 (95% CI 0.99 -1.67) adjusted by age group and period of diagnosis compared to ductal carcinoma.Conclusions: In our study, incidence rates for CBC are comparable with findings from the literature. A reduction in the incidence of metachronous CBC, thought to be due to adjuvant therapies, is seen in our data. In our cohort, younger age and lobular carcinoma was associated with increased risk for CBC.Keywords Metachronous contralateral breast cancer, lobular carcinoma, incidence rates, year of diagnosis, follow-up period [3]

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“…47 Of note, the development of CBC in the Danish registry study was independent of time since a patient’s first cancer across all ages, with steady rates over 10 years of follow-up. 11 …”

Section: Risk Of In-breast Events In Older Breast Cancer Survivorsmentioning

confidence: 99%

“…Further, studies have consistently shown that the risk of second breast cancer events in survivors does not plateau with time, suggesting that there may be continued benefit of mammography indefinitely. 10,11 Explicit guidance on how to approach surveillance in older or frail breast cancer survivors is lacking. Further, the limited data regarding surveillance in older cancer survivors across all cancers is now widely recognized as a significant research gap and priority.…”

Section: Introductionmentioning

confidence: 99%

Surveillance Mammography in Older Patients With Breast Cancer—Can We Ever Stop?

et al. 2017

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Importance Approximately 4–5% of breast cancer survivors will develop a new ipsilateral or contralateral cancer (“in-breast event”) over the 5 years following diagnosis, and annual surveillance mammography is recommended for those with residual breast tissue. The risk for such in-breast events persists over time, though increasing age at cancer diagnosis and treatment with hormonal therapy are associated with lower risk, and most older breast cancer survivors will ultimately die from non-breast cancer related causes. Specific guidelines for surveillance strategies in older patients are limited. Prospective data on the benefits and harms of surveillance mammography in this population are lacking, and most of the evidence is derived from observational, retrospective data, often in the general population. Observations We review the current recommendations for breast cancer screening and surveillance for older patients, the current evidence for ipsilateral and contralateral breast cancer risks in older breast cancer survivors, and suggested approaches for discussions about surveillance mammography with older patients. We recommend individualized decision-making for surveillance breast imaging in older breast cancer survivors, with consideration of the following strategy for women age ≥70: one-time imaging 6–12 months after completion of local therapy followed by annual or biennial surveillance mammography for healthy women and cessation of mammography in patients whose life expectancy is <5–10 years, regardless of age. Decisions on mammographic surveillance should also incorporate whether hormonal therapy is being administered, whether one’s anticipated life expectancy is extraordinary, and whether one’s individual risk for in-breast events is higher (or lower) than for average-risk breast cancer survivors. Conclusions and Relevance We propose re-framing discussions around surveillance mammography in older breast cancer survivors and to consider cessation, while taking into account life expectancy, the estimated risk for subsequent in-breast events and patient preferences.

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Incidence of metachronous contralateral breast cancer in Denmark 1978–2009

Cited by 31 publications

References 35 publications

Breast cancer risk in BRCA1/2 mutation carriers and noncarriers under prospective intensified surveillance

Breast cancer risk in BRCA1/2 mutation carriers and noncarriers under prospective intensified surveillance

Incidence of metachronous contralateral breast cancer in the Canton of Zurich: a population-based study of the cancer registry

Surveillance Mammography in Older Patients With Breast Cancer—Can We Ever Stop?

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