Non–Small-Cell Lung Cancer After Breast Cancer: A Population-Based Study of Clinicopathologic Characteristics and Survival Outcomes in 3529 Women

Milano, Michael T.; Strawderman, Robert L.; Venigalla, Sriram; Ng, Kimberly; Travis, Lois B.

doi:10.1097/jto.0000000000000213

Cited by 34 publications

(35 citation statements)

References 45 publications

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“…These patients also more often treated with surgery and not radiation compared to NSCLC patients without previous malignancy. This was reported in breast cancer survivors who developed NSCLC and was also postulated to be due to heightened surveillance 25 .…”

Section: Discussionmentioning

confidence: 90%

“…Standardized incidence ratios (SIRs), defined as the ratio of observed over expected (O/E) rates of NSCLC cancers were calculated and adjusted by person-years at risk 24, 25 . The observed value was derived by looking at those patients who developed NSCLC (numerator) after the first primary of interest and was divided by all patients diagnosed with the same primary but who did not develop NSCLC (denominator).…”

Section: Methodsmentioning

confidence: 99%

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Non–Small Cell Lung Cancer as a Second Primary Among Patients With Previous Malignancy: Who Is at Risk?

Nelson

Kim

et al. 2017

Clinical Lung Cancer

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Background Patients with prior malignancies may be at increased risk for non-small cell lung cancer (NSCLC). However, the extent of risk is unknown for many cancer types and it is unclear who may benefit from screening. Methods The Surveillance, Epidemiology and End Results dataset from 1992-2012 was used to identify patients with prior malignancies who were diagnosed with NSCLC ≥6 months after their initial cancer. Standardized incidence ratios (SIR) for NSCLC were calculated as a ratio of observed to expected cases adjusted by person-years at risk. Cancers with SIR >1.0 had higher risk for NSCLC than expected. Analyses were stratified by sex, radiation, and histology. Results Among cancer survivors, 32,058 developed NSCLC. Smoking-related (lung, head and neck, bladder) and hematologic malignancies regardless of prior radiation therapy had the highest SIR for NSCLC (range 1.97-4.88). Prior colorectal and renal cancer survivors also had increased SIR for NSCLC (1.16 and 1.21, respectively). Women with previous pancreatic cancer treated with radiation, breast cancer with or without radiation, and those with thyroid cancer demonstrated higher SIR for lung adenocarcinoma. Men with prior irradiated prostate cancer also had elevated SIR (1.08, CI 1.01-1.15) for lung adenocarcinoma. Patients with melanoma, prostate or uterine cancer had lower SIR for NSCLC than expected. Conclusions Smoking-related malignancies had the highest risk for NSCLC. Radiation conferred elevated risk for NSCLC for certain cancers. Melanoma, prostate, uterine cancer survivors were at low risk for NSCLC. These results may help identify high-risk screening candidates in the growing population of cancer survivors.

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Section: Discussionmentioning

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Non–Small Cell Lung Cancer as a Second Primary Among Patients With Previous Malignancy: Who Is at Risk?

Nelson

Kim

et al. 2017

Clinical Lung Cancer

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“…In other cases the increased risk results from historical exposure to a carcinogen such as cigarette smoke [23,24]. In many such cases the diagnosis of lung cancer is the primary driver of future life expectancy, for example accounting for 12% of deaths in (HNSCC) patients in the Surveillance Epidemiology and End Results (SEER) database [24] and for 100% of cancer related deaths reported in a recently reported small cohort of early stage bladder cancer patients with a second primary lung malignancy [25]. …”

Section: Discussionmentioning

confidence: 99%

Patients with a Previous History of Malignancy Undergoing Lung Cancer Screening: Clinical Characteristics and Radiologic Findings

Halpenny

Cunningham

Long

et al. 2016

Journal of Thoracic Oncology

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Introduction The aim of this study was to describe the clinical characteristics and radiological findings in patients with a previous history of malignancy who underwent CT screening for lung cancer. Methods Patients with a previous history of malignancy with a life expectancy of at least 5 years referred for lung cancer screening between 5/2/2011 and 9/24/2014 were included. CT features assessed included nodule size, morphology and number. The lung-RADs scoring system was retrospectively applied to all studies. Results 139 patients were studied (mean age 66 years, median pack year smoking history of 50). All had a previous history of cancer, most commonly breast 60 (43%), head/neck 26 (19%) and lung 16 (12%). 42 (30%) patients had a positive screening study. 7 (5%) patients were diagnosed with lung cancer. 1 (1%) patient was diagnosed with a radiation induced chest wall sarcoma. 42 (30%) patients had a positive chest CT as per NCCN Lung Cancer Screening nodule follow-up algorithm. Conclusion The rate of lung cancer diagnosis in our patient population is higher than in several previously published studies. Smokers with a prior history of malignancy may be in a particularly high risk group for the development of subsequent lung cancer.

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“…Clinical decision‐making for patients presenting with lung‐2 sometimes can be challenging because of the limited and conflicting information on prognosis. A study of Hodgkin lymphoma patients who developed lung‐2 showed inferior overall survival of lung‐2 compared to lung‐1, whereas the overall survival of lung‐2 among breast cancer survivors was not worse compared to lung‐1 . The reduced overall survival (if any) is, however, not surprising, given the non‐negligible mortality contribution of the first primary cancer, and does not necessarily indicate more aggressive behavior of lung‐2.…”

Section: Introductionmentioning

confidence: 98%

Mortality of lung cancer as a second primary malignancy: A population‐based cohort study

et al. 2019

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Lung cancer as a second primary malignancy (lung‐2) is increasingly common, but its prognosis is poorly understood. This study aims to examine the overall and cancer‐specific survival of patients diagnosed with lung‐2 compared to lung‐1. Primary lung cancer patients diagnosed from 1988 to 2014 in the Surveillance, Epidemiology, and End Results (SEER) program were included. Lung‐2 was identified in patients with a previous diagnosis of nonlung primary malignancy in SEER. Hazard ratios (HRs) of overall and lung cancer‐specific mortality were estimated among patients with lung‐2 compared to lung‐1, adjusting for age and calendar period at diagnosis, sex, race, socioeconomic status, tumor stage, histology, tumor grade, and treatment. A total of 679 541 and 85 758 patients were identified as lung‐1 and lung‐2, respectively. Compared to lung‐1, patients with lung‐2 were more likely to be diagnosed at localized stage, with smaller primary tumor, and treated with surgery. Lung‐2 patients were at lower risk of lung cancer‐specific mortality in the first 5 years (HR, 0.77; 95% CI, 0.76‐0.78 at <1 year; HR, 0.87; 95% CI, 0.86‐0.89 from 1 to <5 years) but at higher risk thereafter (HR, 1.32; 95% CI, 1.27‐1.37 from 5 to 10 years), independent of tumor characteristics and cancer treatment. Similar pattern was found for overall mortality, although the survival benefit was restricted to the first year after diagnosis. Patients diagnosed with lung‐2 face a favorable lung cancer‐specific survival within the early period after diagnosis. A conservative approach to manage lung‐2 solely based on malignancy history is not supported.

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Non–Small-Cell Lung Cancer After Breast Cancer: A Population-Based Study of Clinicopathologic Characteristics and Survival Outcomes in 3529 Women

Cited by 34 publications

References 45 publications

Non–Small Cell Lung Cancer as a Second Primary Among Patients With Previous Malignancy: Who Is at Risk?

Non–Small Cell Lung Cancer as a Second Primary Among Patients With Previous Malignancy: Who Is at Risk?

Patients with a Previous History of Malignancy Undergoing Lung Cancer Screening: Clinical Characteristics and Radiologic Findings

Mortality of lung cancer as a second primary malignancy: A population‐based cohort study

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