Previously diagnosed multiple primary malignancies in patients with breast carcinoma in Western Sweden between 2007 and 2018

Jenny Nyqvist,Khalil Helou,Elisabeth Kenne Sarenmalm,Per Karlsson,Anikó Kovács,Zakaria Einbeigi,Salmir Nasic,Toshima Z Parris

doi:10.1007/s10549-020-05822-z

Abstract

PurposeMultiple primary malignancies (MPMs) caused by breast cancer treatment are well described, but only few studies to date describe which other previous primary malignancies (OPPMs) occur before breast cancer. The purpose of the present study was to evaluate the prevalence of OPPMs in patients with breast cancer between 2007 and 2018 in Western Sweden.MethodsPatient selection was performed using both pathology reports at Sahlgrenska University Hospital (Sweden) and the Swedish Cancer Registry. All newly diagnosed breast cancer patients were screened for presence of OPPM.ResultsIn total, 8031 breast cancer patients were diagnosed at Sahlgrenska University Hospital between 2007 and 2018. The prevalence of breast cancer patients with OPPMs (n = 414) increased from on average 2.6% to 8.2% during this 12-year period and ranged from 17 to 59 patients annually. The most striking increase in prevalence was found among the gynecological tumors (endometrium and ovarian adenocarcinomas), malignant melanomas and gastrointestinal malignancies. These findings were validated using data of the Swedish Cancer Registry.ConclusionsThe overall survival rates for cancer patients have improved tremendously during the past 40 years, in part due to individually tailored therapies and screening programs. Our study revealed an increasing trend of OPPMs in breast cancer patients.

Highlights

During the past 40 years, overall survival rates have improved for cancer patients due to better prevention, earlier diagnosis with different screening programs and individually tailored therapies [1]
8031 patients were diagnosed with breast cancer between 2007 and 2018 at Sahlgrenska University Hospital, of which 414 patients had previously been diagnosed with other previous primary malignancies (OPPMs) (Table 1)
In 2007, 3.3% of the newly diagnosed breast cancer patients (n = 545) were found to have OPPMs, while this number had risen to 6.6% in 2018

Summary

Introduction

During the past 40 years, overall survival rates have improved for cancer patients due to better prevention, earlier diagnosis with different screening programs and individually tailored therapies [1]. Cancer patients are at a 10% elevated risk of developing additional primary malignancies in other organs [2, 3]. These so-called multiple primary malignancies (MPMs) are not metastases, but rather new primary tumors with differing histogenesis that can be verified by immunohistochemical examination. The phenomena of MPMs were described by Billroth et al as early as 1889, followed by Warren and Gates in 1932 and Moertel in 1977 [4]. Warren and Gates went a step further by stratifying MPMs into metachronous (> 6 months apart) and synchronous type (≤ 6 months in-between the primary malignancies)

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