Primary Lung Cancer After Treatment for Breast Cancer

Qian, Long; Wang, Yan; Che, Guowei

doi:10.2147/ijwh.s338910

Cited by 11 publications

(10 citation statements)

References 46 publications

(76 reference statements)

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“…The authors note that although the absolute risk is relatively low, the growing number of long-time survivors after breast cancer treatment highlights the need for advances in normal tissue sparing radiation techniques [ 47 , 48 ]. Encouragingly, some novel approaches recently described appear to achieve this end, based on dosimetric calculations [ 51 ].…”

Section: Sex and Age Modulate Secondary Cancers Attributable To Exter...mentioning

confidence: 99%

“…TRT presents a challenge for risk modulation to healthy organs since healthy tissue sparing strategies which can be deployed with external radiation [ 51 ] are not relevant when the radioactive agent is administered systemically. Instead, TRT trials incorporate individual dosimetry to predict risk of toxicity as well as efficacy [ 98 , 109 , 110 , 111 ].…”

Section: Sex Hormonal Status and Targeted Radionuclide Therapy: A Cha...mentioning

confidence: 99%

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Modulation of Secondary Cancer Risks from Radiation Exposure by Sex, Age and Gonadal Hormone Status: Progress, Opportunities and Challenges

Biegon

Cohen

Franceschi

2022

JPM

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Available data on cancer secondary to ionizing radiation consistently show an excess (2-fold amount) of radiation-attributable solid tumors in women relative to men. This excess risk varies by organ and age, with the largest sex differences (6- to more than 10-fold) found in female thyroid and breasts exposed between birth until menopause (~50 years old) relative to age-matched males. Studies in humans and animals also show large changes in cell proliferation rates, radiotracer accumulation and target density in female reproductive organs, breast, thyroid and brain in conjunction with physiological changes in gonadal hormones during the menstrual cycle, puberty, lactation and menopause. These sex differences and hormonal effects present challenges as well as opportunities to personalize radiation-based treatment and diagnostic paradigms so as to optimize the risk/benefit ratios in radiation-based cancer therapy and diagnosis. Specifically, Targeted Radionuclide Therapy (TRT) is a fast-expanding cancer treatment modality utilizing radiopharmaceuticals with high avidity to specific molecular tumor markers, many of which are influenced by sex and gonadal hormone status. However, past and present dosimetry studies of TRT agents do not stratify results by sex and hormonal environment. We conclude that cancer management using ionizing radiation should be personalized and informed by the patient sex, age and hormonal status.

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Section: Sex and Age Modulate Secondary Cancers Attributable To Exter...mentioning

confidence: 99%

Section: Sex Hormonal Status and Targeted Radionuclide Therapy: A Cha...mentioning

confidence: 99%

Modulation of Secondary Cancer Risks from Radiation Exposure by Sex, Age and Gonadal Hormone Status: Progress, Opportunities and Challenges

Biegon

Cohen

Franceschi

2022

JPM

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“…In this case, the patient had a number of risk factors for developing second primary lung cancer, including older age at breast cancer diagnosis (>50 years old) and a strong family history of malignancy [ 10 ]. Although previous studies have suggested a higher incidence rate of second primary lung cancers among patients with ER, PR, and HER-2 negativity [ 10 - 12 ], our patient had triple positive breast cancer, suggesting a potential alternate pathway to the development of her lung cancer.…”

Section: Discussionmentioning

confidence: 99%

An Unexpected Diagnosis of Second Primary Malignancy in a Breast Cancer Survivor: A Case Report

Haque,

Mushtaq,

Alkhatib

et al. 2023

Cureus

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Background: Breast cancer survival rates are increasing more than ever with the development of better diagnostic and therapeutic techniques. Survivors of breast cancer have an increased risk of developing second primary malignancies, which may be mistaken for breast cancer recurrence and lead to delayed diagnosis and poor prognosis. Case report: We report a case of a 62-year-old female who presented with shortness of breath and bone pain. She had a history of left triple-positive invasive ductal carcinoma (T1N0M0) treated with bilateral skin-sparing mastectomy, adjuvant Taxotere, and trastuzumab-based therapy and then continued on trastuzumab and letrozole. She underwent imaging to explore the source of her symptoms at which new pulmonary nodules were discovered. During workup, she was found to have elevated tumor markers. They were initially suspected to be breast cancer recurrence metastases based on elevated tumor markers; however, further investigations confirmed that the nodules were a second primary lung adenocarcinoma with a different molecular profile. The patient had disease progression despite chemotherapy and eventually succumbed to her disease. Conclusion: This case highlights the importance of considering second primary malignancies in breast cancer survivors and utilizing advanced diagnostic modalities to efficiently diagnose such cases.

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“…Lung cancer often appears in metachronous cancer in the form of a second primary cancer. There is evidence that the risk of primary lung cancer after treatment of breast cancer increases because smoking habits, age and the disease stage of breast cancer may affect the risk of secondary primary lung cancer in breast cancer patients[ 38 ]. Therefore, the regular follow-up of patients, including monitoring the lungs after 6 mo, should be carried out while breast cancer is treated.…”

Section: Discussionmentioning

confidence: 99%

High incidence combination of multiple primary malignant tumors of the digestive system

Yang¹,

Zhang²,

Xue³

et al. 2022

World J Gastroenterol

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BACKGROUND Clinical reports of multiple primary malignant tumors (MPMTs) in the digestive system are increasing. In China, although the survival rate of patients with MPMTs is increasing, the quality of life is very low. Many patients have reached the advanced stage when the second primary tumor is found, resulting in no early intervention and treatment. This is due to the misunderstanding of MPMTs by clinicians, who treat such tumors as metastases. Therefore, before a patient has a second primary tumor, doctors should understand some common combinations of digestive system MPMTs to provide clinical guidance to the patient. AIM To explore the high incidence combination of digestive system MPMTs under heterochronism and synchronization. METHODS A total of 1902 patients with MPMTs at Peking Union Medical College Hospital were analyzed retrospectively. They were divided into metachronous MPMT and synchronous MPMT groups, and then the high incidence combinations of the first primary cancer and the second primary cancer in metachronous cancer and synchronous cancer were sorted. Sex and age differences between metachronous and synchronous tumors were tested by the chi square test and t test, respectively. A P value < 0.05 was considered as statistically significant, and SPSS version 26.0 (SPSS Inc., Chicago, Illinois, United States) was used for statistical analysis. RESULTS Among the 1902 patients with MPMTs confirmed by pathology, 1811 (95.2%) cases were secondary primary cancers, 89 (4.7%) cases were tertiary primary cancers, and 2 (0.1%) cases were quaternary primary cancers. Most (88.2%) of the secondary primary cancers were identified as metachronous multiple primary cancers six months after diagnosis of the first primary cancer. The top ten most common MPMTs in the first primary cancer group ranged from high to low as follows: Breast cancer, thyroid cancer, nonuterine cancer, lung cancer, colon cancer, kidney cancer, uterine cancer, bladder cancer, rectal cancer, and gastric cancer. The highest incidence rate of the first primary cancer in male metachronous cancer was lung cancer (11.6%), the highest incidence rate of the second primary cancer was still lung cancer (24.9%), the highest incidence rate of the first primary cancer in female metachronous cancer was breast cancer (32.7%), and the highest incidence rate of the second primary cancer was lung cancer (20.8%). Among them, breast cancer, nonuterine cancer and uterine cancer were female-specific malignant tumor types, and thyroid cancer also accounted for 79.6% of female patients. The top five metachronous cancer combinations, independent of female-specific malignant tumor types and thyroid cancer, were colon cancer and lung cancer (26 cases), kidney cancer and lung cancer (25 cases), rectal cancer and lung cancer (20 cases), gastric cancer and lung cancer (17 cases), and bladder cancer and lung cance...

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Primary Lung Cancer After Treatment for Breast Cancer

Cited by 11 publications

References 46 publications

Modulation of Secondary Cancer Risks from Radiation Exposure by Sex, Age and Gonadal Hormone Status: Progress, Opportunities and Challenges

Modulation of Secondary Cancer Risks from Radiation Exposure by Sex, Age and Gonadal Hormone Status: Progress, Opportunities and Challenges

An Unexpected Diagnosis of Second Primary Malignancy in a Breast Cancer Survivor: A Case Report

High incidence combination of multiple primary malignant tumors of the digestive system

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