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. 2020 Jun 4;15(6):e0232800.
doi: 10.1371/journal.pone.0232800. eCollection 2020.

Risk of second primary breast cancer among cancer survivors: Implications for prevention and screening practice

Yao Cheng  1 , Ziming Huang  1 , Qing Liao  2 , Xingchen Yu  2 , Hongyu Jiang  2 , Yangting He  2 , Shuang Yao  2 , Shaofa Nie  2 , Li Liu  2
Affiliations

Risk of second primary breast cancer among cancer survivors: Implications for prevention and screening practice

Yao Cheng et al. PLoS One. .

Abstract

Second primary breast cancer (SPBC) is becoming one of the major obstacles to breast cancer (BC) control. This study was aimed to determine the trend of SPBC incidence over time and the risk of developing SPBC in site-specific primary cancer survivors in the United States. The Surveillance, Epidemiology, and End Results (SEER) 13 registry (1992-2015) was used to identify SPBC patients with previous malignancies. Standardized incidence ratio (SIR) was computed to compare the incidence rates of the observed cases of SPBC in cancer survivors over the expected cases in the general population. Elevated risk of SPBC was observed in women with previous BC (SIR = 1.74) or thyroid cancer (SIR = 1.17). Women with initial skin melanoma in older age (≥50 years) (SIR = 1.11), or White race (SIR = 1.11) presented an elevated incidence of SPBC than the general female population. Besides, Asian/Pacific Islander (API) women with cancer of corpus uteri, ovary, bladder, or kidney were prone to developing SPBC when compared with the general population, with SIRs of 1.61, 1.35, 1.48, and 1.70, respectively. Male BC patients showed profound risk of developing SPBC (SIR = 34.86). Male leukemia patients also presented elevated risk of developing SPBC (SIR = 2.06). Our study suggests significant increase of SPBC in both sexes in the United States. Elevated risk of SPBC exists in survivors with primary BC, female thyroid cancer, male leukemia, and API female cancer patients with primary genitourinary cancer. Our study is helpful in developing strategies for BC control and prevention on specific first primary cancer survivors with an elevated risk of SPBC.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig 1
Fig 1. Trends in age-standardized rates of first primary and second primary breast cancer patients.
Abbreviations: AAPC: average annual percentage change; API: Asian/Pacific Islander; FPBC: first primary breast cancer; SPBC: second primary breast cancer. Age-standardized rates of first primary per 100,000 and second primary breast cancer per 1,000,000 for female (A) and male (B), and age-standardized rates of second primary breast cancer per 1,000,000 for women stratified by age (C) and race (D).
Fig 2
Fig 2. Risk of female second primary breast cancer after previous malignancy stratified by initial primary site and age group.
Fig 3
Fig 3. Risk of female second primary breast cancer after previous malignancy stratified by initial primary site and race.
See this image and copyright information in PMC

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