Radiation Therapy for Invasive Breast Cancer Increases the Risk of Second Primary Lung Cancer: A Nationwide Population-Based Cohort Analysis

Huang, Yi-Jhih; Huang, Tsai-Wang; Lin, Fu-Huang; Chung, Chi‐Hsiang; Tsao, Chang‐Huei; Chien, Wu-Chien

doi:10.1016/j.jtho.2017.01.021

Cited by 55 publications

(50 citation statements)

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“…Postmastectomy radiotherapy for BC patients could sharply increase the risk of second primary lung cancer, especially in ipsilateral lung, among ever-smokers ( 8 ). After an analysis of the Longitudinal Health Insurance Database, Huang et al found that the incidence of second primary lung cancer was higher in the radiotherapy group than in the non-radiotherapy group for BC patients ( 39 ). Another retrospective study from 12 U.S. population-based cancer registries also indicated an increased risk of second non-breast cancers ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Second Primary Lung Cancer After Breast Cancer: A Population-Based Study of 6,269 Women

et al. 2018

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Purpose: Breast cancer (BC) and lung cancer are the most two common cancers with highest morbidity and mortality for women. With prolonged survival, there comes the possibility that BC patients will develop second primary cancers. We evaluate the characteristics, incidence and survival of second primary non-small cell lung cancer (BC-NSCLC) and small cell lung cancer (BC-SCLC) after breast cancer.Patients and methods: Second primary lung cancer risks using standardized incidence ratios (SIRs) [95% confidence intervals (95% CIs)] were calculated among breast cancer patients in SEER-18 (2000–2014). Survival outcomes were also analyzed for both BC-NSCLC and BC-SCLC.Results: A total of 6,269 second lung cancer patients after a localized or regional BC were identified. The incidence rate was modestly higher compared to the general population (SIR = 1.03; 95%CI: 1.00–1.06). For ER-, PR- and HER2- groups, SIRs were 1.26, 1.16, 1.13, respectively (all p < 0.05). Triple negative breast cancer (TNBC) patients have an even higher incidence rate of lung cancer (SIR = 1.59, 95%CI: 1.29–1.94). Elevated SIRs were also observed among the following groups: within 1 year after BC diagnosed, a young age at BC diagnosed, black people, poorly or undifferentiated histological grade of breast cancer. Median survival (MST) after localized, regional and distant BC-NSCLC was 68.0, 26.0, and 6.0m. Five-year survival rates for BC-NSCLC were 53.9, 29.8 and 5.7% in each stage, which were significantly higher compared to first primary NSCLC (all p < 0.001). ER-/PR- or TNBC were unfavorable prognostic factors for BC-NSCLC. The survival rates of BC-SCLC were no significant different compared to first primary SCLC.Conclusion: BC patients, especially for TNBC, are at a high risk of developing second primary lung cancers. BC history may be a favorable prognostic factor for NSCLC (but not SCLC) patients. Clinicians should closely follow up BC patients with high-risk factors.

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Section: Discussionmentioning

confidence: 99%

Second Primary Lung Cancer After Breast Cancer: A Population-Based Study of 6,269 Women

et al. 2018

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“…[ 17 ] In addition, radiotherapy for primary BC could induce angiosarcoma [ 18 ] and lung cancer. [ 19 , 20 ] Older radiotherapy techniques are suggested to induce ipsilateral lung cancer, but no clear evidence has been demonstrated for modern radiotherapy techniques. [ 21 ]…”

Section: Introductionmentioning

confidence: 99%

Problems to affect long-term survival for breast cancer patients

Liu

Feng

et al. 2018

Medicine

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“…Genetic predisposition and environmental exposure to common carcinogens may be related to the development of multiple cancers. In addition, secondary lung cancer after cancer at other sites might be associated with previous chemotherapy or radiation therapy [29,30].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for primary lung cancer among never-smoking women in South Korea: a retrospective nationwide population-based cohort study

Kim

et al. 2020

Korean J Intern Med

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Background/Aims:We performed a large-scale, retrospective, nationwide, cohort study to investigate the risk factors for lung cancer among never-smoking Korean females. Methods:The study data were collected from a general health examination and questionnaire survey of eligible populations conducted between January 1, 2003 and December 31, 2004; the data were acquired from the tailored big data distri-bution service of the National Health Insurance Service. After a 1-year clearance period, 5,860,922 of 6,318,878 never-smoking female participants with no previous history of lung cancer were investigated. After a median follow-up of 11.4 years, 43,473 (0.74%) participants were defined as "newly diagnosed lung cancer". Results:After adjusting for all variables at baseline, the variables older age, lower body mass index (BMI), less exercise, frequent alcohol drinking, meat-based diet, rural residence, and previous history of cancer were associated with a higher incidence of lung cancer. Low BMI (< 18.5 kg/m 2 : hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.27 to 1.40) was a significant independent risk fac-tor; as BMI decreased, HR increased. Negative associations between BMI and lung-cancer development were also observed after controlling for age (p for trend < 0.001). Drinking alcohol one to two times a week (HR, 1.25; 95% CI, 1.21 to 1.28) and eating a meat-based diet (HR, 1.08; 95% CI, 1.01 to 1.15) were associated with lung-cancer incidence. Conclusions:Modifiable baseline characteristics, such as BMI, exercise, alcohol consumption, and diet, are risk factors for lung-cancer development among nev-er-smoking females. Thus, lifestyle modifications may help prevent lung cancer.

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Radiation Therapy for Invasive Breast Cancer Increases the Risk of Second Primary Lung Cancer: A Nationwide Population-Based Cohort Analysis

Abstract: The incidence of second primary lung cancer was significantly higher in the RT group than in the non-RT group for individuals with previous BC. Patients with BC treated by RT should be extensively surveyed to assess the incidence of subsequent lung cancer.

Cited by 55 publications

References 29 publications

Second Primary Lung Cancer After Breast Cancer: A Population-Based Study of 6,269 Women

Second Primary Lung Cancer After Breast Cancer: A Population-Based Study of 6,269 Women

Problems to affect long-term survival for breast cancer patients

Risk factors for primary lung cancer among never-smoking women in South Korea: a retrospective nationwide population-based cohort study

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