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Table 3 Associations between breast cancer treatment and risk of developing second primary cancer among 16,004 women diagnosed with a first primary unilateral invasive breast cancer between 1990 to 2016 and followed through 2017a,b

From: Risk of second primary cancer among women in the Kaiser Permanente Breast Cancer Survivors Cohort

 

Age-adjusted HRs (95% CIs)c

Multivariable-adjusted HRs (95% CIs)d

Site-specific second primary cancer

Radiotherapy

Chemotherapy

Endocrine therapye

Radiotherapy

Chemotherapy

Endocrine therapye

All second cancer

1.10 (0.99–1.22)

0.86 (0.77–0.97)

0.74 (0.65–0.84)

1.13 (1.01–1.25)

0.87 (0.78–0.98)

0.78 (0.68–0.89)

All second non-breast cancer

1.04 (0.92–1.17)

0.88 (0.77–1.01)

0.94 (0.80–1.11)

1.06 (0.93–1.20)

0.89 (0.77–1.02)

0.99 (0.84–1.17)

Oral cavity, pharynx

0.53 (0.24–1.17)

0.60 (0.23–1.59)

1.40 (0.41–4.72)

0.52 (0.24–1.13)

0.60 (0.23–1.61)

1.56 (0.43–5.65)

Peritoneum, omentum, mesentery

1.23 (0.33–4.57)

0.71 (0.19–2.65)

2.38 (0.29–19.60)

1.17 (0.31–4.42)

0.76 (0.21–2.70)

2.33 (0.31–17.80)

Soft tissue sarcoma

2.38 (1.20–4.72)

1.30 (0.78–2.19)

0.77 (0.40–1.50)

2.36 (1.17–4.78)

1.28 (0.76–2.17)

0.69 (0.34–1.38)

Melanoma of the skin

1.04 (0.62–1.74)

1.32 (0.79–2.22)

1.20 (0.57–2.55)

1.02 (0.61–1.70)

1.30 (0.78–2.17)

1.01 (0.46–2.18)

Contralateral breastf

1.17 (0.95–1.43)

0.81 (0.66–1.01)

0.45 (0.35–0.56)

1.22 (0.99–1.51)

0.82 (0.66–1.02)

0.48 (0.38–0.60)

Corpus uteri

1.36 (0.90–2.05)

1.10 (0.72–1.66)

1.03 (0.61–1.73)

1.38 (0.91–2.11)

1.10 (0.72–1.68)

1.06 (0.61–1.86)

Leukemia

1.68 (0.83–3.40)

0.72 (0.35–1.49)

0.81 (0.36–1.83)

1.78 (0.89–3.57)

0.75 (0.36–1.58)

0.83 (0.35–1.97)

Acute myeloid leukemia

3.38 (0.75–15.28)

1.45 (0.47–4.49)

1.00 (0.19–5.24)

3.47 (0.74–16.18)

1.35 (0.44–4.15)

0.92 (0.13–6.52)

Myelodysplastic syndromeg

2.31 (0.66–8.06)

2.84 (0.96–8.39)

1.36 (0.31–5.93)

2.09 (0.59–7.37)

3.01 (1.01–8.94)

1.08 (0.21–5.59)

  1. Bold font indicates statistical significance
  2. Abbreviations HR—Hazard Ratio, CI—Confidence interval, KP—Kaiser Permanente
  3. aResults are presented for all second primary cancers, all second non-breast cancers, and select site-specific second cancers (overall SIRs ≥ 1.50)
  4. bFine and Gray regression models were used to estimate subdistribution hazard ratios accounting for death and other invasive cancer (site-specific analyses only) as a competing event
  5. cAdjusted for age at first breast cancer (continuous)
  6. dAdjusted for age at first breast cancer (continuous), diagnosis year for first breast cancer (< 1995, 1995- < 2000, 2000- < 2005, ≥ 2005), study site (KP Colorado, KP Northwest, KP Washington), and mutually adjusted for radiotherapy (yes, no), chemotherapy (yes, no), endocrine therapy (yes, no)
  7. eRestricted to women diagnosed with a first estrogen receptor-positive breast cancer
  8. fExcludes women with bilateral mastectomies (n = 1,042)
  9. gAnalyses for myelodysplastic syndrome are restricted to 2001–2017 (n = 12,746)
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Breast Cancer Research

ISSN: 1465-542X

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