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Characteristics and Survival of Breast Cancer Patients with Multiple Synchronous or Metachronous Primary Cancers.

Lee J, Park S, Kim S, Kim J, Ryu J, Park HS, Kim SI, Park BW - Yonsei Med. J. (2015)

Bottom Line: At ≤5 years, patients with MPCs were older and demonstrated significantly worse survival despite a higher proportion of patients with lower-stage MPCs.Nevertheless, an increased risk of death in patients with MPCs did not reach statistical significance at >5 years.Stage-matched analysis revealed that the implications of MPCs on survival were more evident in the early stages of breast disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Newly developed extra-mammary multiple primary cancers (MPCs) are an issue of concern when considering the management of breast cancer survivors. This study aimed to investigate the prevalence of MPCs and to evaluate the implications of MPCs on the survival of breast cancer patients.

Materials and methods: A total of 8204 patients who underwent surgery at Severance Hospital between 1990 and 2012 were retrospectively selected. Clinicopathologic features and survival over follow-up periods of ≤5 and >5 years were investigated using univariate and multivariate analyses.

Results: During a mean follow-up of 67.3 months, 962 MPCs in 858 patients (10.5%) were detected. Synchronous and metachronous MPCs were identified in 23.8% and 79.0% of patients, respectively. Thyroid cancer was the most prevalent, and the second most common was gynecologic cancer. At ≤5 years, patients with MPCs were older and demonstrated significantly worse survival despite a higher proportion of patients with lower-stage MPCs. Nevertheless, an increased risk of death in patients with MPCs did not reach statistical significance at >5 years. The causes of death in many of the patients with MPCs were not related to breast cancer. Stage-matched analysis revealed that the implications of MPCs on survival were more evident in the early stages of breast disease.

Conclusion: Breast cancer patients with MPCs showed worse survival, especially when early-stage disease was identified. Therefore, it is necessary to follow screening programs in breast cancer survivors and to establish guidelines for improving prognosis and quality of life.

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Related in: MedlinePlus

Stage-matched overall survival curve (A, B, and C) at ≤5 years and (D, E, and F) at >5 years. (A and D) Stage 0-I; (B and E) stage II; and (C and F) stage III disease. The dotted line represents patients with breast cancer alone, and the solid line indicates patients with multiple primary cancers.
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Figure 3: Stage-matched overall survival curve (A, B, and C) at ≤5 years and (D, E, and F) at >5 years. (A and D) Stage 0-I; (B and E) stage II; and (C and F) stage III disease. The dotted line represents patients with breast cancer alone, and the solid line indicates patients with multiple primary cancers.

Mentions: When adjusting for age, TNM stage, and ER expression at diagnosis of breast cancer, patients with MPCs were significantly associated with an increased risk of death at ≤5 years (Table 4). However, a slightly increased risk of death in patients with MPCs did not reach statistical significance at >5 years. Older age, advanced TNM stage, and ER-positive disease were independent prognostic factors at >5 years. A stage-matched subgroup analysis showed that patients with MPCs had significantly worse OS than the breast-cancer-alone group for stage 0-I disease at both ≤5 and >5 years and for stage II disease at ≤5 years (Fig. 3). Nevertheless, no statistical difference in OS was noted between stage II disease at >5 years and stage III disease irrespective of follow-up duration.


Characteristics and Survival of Breast Cancer Patients with Multiple Synchronous or Metachronous Primary Cancers.

Lee J, Park S, Kim S, Kim J, Ryu J, Park HS, Kim SI, Park BW - Yonsei Med. J. (2015)

Stage-matched overall survival curve (A, B, and C) at ≤5 years and (D, E, and F) at >5 years. (A and D) Stage 0-I; (B and E) stage II; and (C and F) stage III disease. The dotted line represents patients with breast cancer alone, and the solid line indicates patients with multiple primary cancers.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541649&req=5

Figure 3: Stage-matched overall survival curve (A, B, and C) at ≤5 years and (D, E, and F) at >5 years. (A and D) Stage 0-I; (B and E) stage II; and (C and F) stage III disease. The dotted line represents patients with breast cancer alone, and the solid line indicates patients with multiple primary cancers.
Mentions: When adjusting for age, TNM stage, and ER expression at diagnosis of breast cancer, patients with MPCs were significantly associated with an increased risk of death at ≤5 years (Table 4). However, a slightly increased risk of death in patients with MPCs did not reach statistical significance at >5 years. Older age, advanced TNM stage, and ER-positive disease were independent prognostic factors at >5 years. A stage-matched subgroup analysis showed that patients with MPCs had significantly worse OS than the breast-cancer-alone group for stage 0-I disease at both ≤5 and >5 years and for stage II disease at ≤5 years (Fig. 3). Nevertheless, no statistical difference in OS was noted between stage II disease at >5 years and stage III disease irrespective of follow-up duration.

Bottom Line: At ≤5 years, patients with MPCs were older and demonstrated significantly worse survival despite a higher proportion of patients with lower-stage MPCs.Nevertheless, an increased risk of death in patients with MPCs did not reach statistical significance at >5 years.Stage-matched analysis revealed that the implications of MPCs on survival were more evident in the early stages of breast disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Newly developed extra-mammary multiple primary cancers (MPCs) are an issue of concern when considering the management of breast cancer survivors. This study aimed to investigate the prevalence of MPCs and to evaluate the implications of MPCs on the survival of breast cancer patients.

Materials and methods: A total of 8204 patients who underwent surgery at Severance Hospital between 1990 and 2012 were retrospectively selected. Clinicopathologic features and survival over follow-up periods of ≤5 and >5 years were investigated using univariate and multivariate analyses.

Results: During a mean follow-up of 67.3 months, 962 MPCs in 858 patients (10.5%) were detected. Synchronous and metachronous MPCs were identified in 23.8% and 79.0% of patients, respectively. Thyroid cancer was the most prevalent, and the second most common was gynecologic cancer. At ≤5 years, patients with MPCs were older and demonstrated significantly worse survival despite a higher proportion of patients with lower-stage MPCs. Nevertheless, an increased risk of death in patients with MPCs did not reach statistical significance at >5 years. The causes of death in many of the patients with MPCs were not related to breast cancer. Stage-matched analysis revealed that the implications of MPCs on survival were more evident in the early stages of breast disease.

Conclusion: Breast cancer patients with MPCs showed worse survival, especially when early-stage disease was identified. Therefore, it is necessary to follow screening programs in breast cancer survivors and to establish guidelines for improving prognosis and quality of life.

Show MeSH
Related in: MedlinePlus