Abstract

With improved survival, more patients with prior breast cancer are at risk of having a second primary cancer diagnosed. The pattern and impact of second primary cancers following breast cancer is important for overall breast cancer therapeutic management. Our study is a first analysis of the trend of second primary tumours over time in terms of incidence, sites with significantly elevated risks and correlation with stage, molecular subtype and therapeutic strategies conducted in Eastern Europe in postmenopausal women with breast cancer. Patients and methods: Our study population included 28 patients with prior breast cancer (BC) and second primary tumours, which were diagnosed and treated in our Institution between 2004 and 2017. The criteria for selection were based on the completeness of the documentation of the first treatment for breast cancer, stage of disease, molecular subtype, the site of origin of the second tumours and the survival data. Results: An increased risk of second primary cancer was associated with the 51–60 years age group (53.6%), with the greater prevalence in patients living in urban environments (82.1%). The use of chemotherapy increased the risk of the occurrence of gynecological second malignancies (75%). Our study is a first analysis of the trend of second primary tumours over time in terms of identifying sites with significantly elevated risks and correlation with therapeutic strategies conducted in Eastern Europe in postmenopausal women with breast cancer. Conclusions: Our study is a first analysis of the trend of second primary tumours over time in terms of correlation with luminal subtype and stage at diagnosis of primary cancer sites with significantly elevated risks and correlation with therapeutic strategies in postmenopausal women with breast cancer conducted in Eastern Europe. The reported time from primary to second primary malignancy onset, with a significantly higher rate for postmenopausal breast cancer patients, was less than one year (50%). With the advances and wider availability of genetic testing (e.g., gene panels), patients diagnosed with multiple primaries should be increasingly investigated for an underlying cancer predisposition. Postmenopausal women with breast cancer may benefit from increased surveillance and advice to avoid second malignancies.

Highlights

  • Breast cancer is a group of malignancies counting more than 500,000 cases at the European level, being by far the most frequently diagnosed neoplasm (28.2% of the total) [1].With significant disparities across Western and Eastern countries, it is accountable as the fourth most frequent cause of death among all types of cancer

  • Our study is a first analysis of the evolution of second primary tumours over time, in terms of correlation with luminal subtype and stage at diagnosis of primary cancer sites with significantly elevated risks and correlation with therapeutic strategies in postmenopausal women with breast cancer (BC), conducted in Eastern Europe

  • The most common Second primary cancer (SPC) in this study population was contralateral breast cancer, which occurred in seven patients (25.0%), followed by malignancies reported in gynecological sites cancer in six patients (21.4%) and gastrointestinal sites in four patients (14.3%)

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Summary

Introduction

With significant disparities across Western and Eastern countries, it is accountable as the fourth most frequent cause of death among all types of cancer. In an analysis per-formed by Autier and colleagues, it is outlined the fact that in some Western countries, BC mortality decreased in recent years by ≥20%, while in Central and Eastern European countries, mortality did not decline or even increased. Such is the case of Romania, which encountered a remarkable increase of 17% in BC mortality [2]. The pattern and impact of second primary cancers following BC are important for overall BC therapeutic management

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