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. 2018 Jun;9(3):197-204.
doi: 10.1007/s12672-018-0330-0. Epub 2018 Mar 19.

Risk of Second Primary Female Genital Malignancies in Women with Breast Cancer: a SEER Analysis

Zhiyu Li  1 , Qi Wu  1 , Junlong Song  1 , Yimin Zhang  1 , Shan Zhu  1 , Shengrong Sun  2
Affiliations

Risk of Second Primary Female Genital Malignancies in Women with Breast Cancer: a SEER Analysis

Zhiyu Li et al. Horm Cancer. 2018 Jun.

Abstract

Breast cancer survivors are at an increased risk of second primary cancers, and the risk factors for the latter may have clinical significance. The aims of our study were to evaluate the incidences and risk factors of second primary female genital cancers (corpus uteri, cervix uteri plus ovary) in a large cohort of breast cancer survivors. Using the Surveillance, Epidemiology, and End Results (SEER) database, we examined the standardized incidence ratio (SIR) and risk factors for second primary female genital cancers observed between 2000 and 2014. Breast cancer survivors had increased SIRs for second corpus uteri cancers and second ovarian cancers and a decreased SIR for second cervical cancers (SIR 1.17, 1.12, and 0.64, respectively). Risk factors of second corpus uteri cancers were the age at first cancer diagnosis, race (black vs. white, aHR = 1.142 95% CI 1.005-1.298), and progesterone receptor (PR) status (PR+ vs. PR-, aHR = 1.131 95% CI 1.004-1.273). In addition, the risk of second ovarian cancer was positively associated with age while inversely associated with race (black vs. white, aHR = 0.691 95% CI 0.555-0.859) and estrogen receptor (ER) status (ER+ vs. ER-, aHR = 0.655 95% CI 0.544-0.788). Age, race, and hormone receptor status are risk factors of developing second female genital cancers among breast cancer survivors. Older age, black race, and a PR+ status in survivors are associated with a higher risk of second corpus uteri cancers. Additionally, older age and an ER- status should increase vigilance for potential second ovarian cancers.

Keywords: Breast cancer; Risk factor; SEER; Second primary female genital cancer.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Cumulative incidence curves of second corpus uteri cancer among breast cancer survivors in different age groups. Cumulative incidence curves of second corpus uteri cancer in PR+ breast cancer survivors compared with PR− survivors. Cumulative incidence curves of second ovarian cancer among breast cancer survivors in different age groups. Cumulative incidence curves of second ovarian cancer in ER+ breast cancer survivors compared with ER− survivors
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