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首页> 外文期刊>BMC Cancer >Increased risk of breast cancer-specific mortality among cancer survivors who developed breast cancer as a second malignancy
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Increased risk of breast cancer-specific mortality among cancer survivors who developed breast cancer as a second malignancy

机译：癌症幸存者的乳腺癌特异性死亡风险增加，作为第二个恶性肿瘤

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Cancer survivors who develop breast cancer as a second malignancy (BCa-2) are common. Yet, little is known about the prognosis of BCa-2 compared to first primary breast cancer (BCa-1). Using the Surveillance, Epidemiology, and End Results database, we conducted a population-based cohort study including 883,881 patients with BCa-1 and 36,313 patients with BCa-2 during 1990–2015. Compared with patients with BCa-1, we calculated hazard ratios (HRs) of breast cancer-specific mortality among patients with BCa-2, using multivariable Cox regression. During the follow-up (median 5.5?years), 114,964 and 3829 breast cancer-specific deaths were identified among BCa-1 and BCa-2 patients, respectively. Patients with BCa-2 had more favorable tumor characteristics and received less intensive treatment e.g., surgery and chemo?/radio-therapy, compared to patients with BCa-1. When adjusting for demographic factors, patients with BCa-2 were at similar risk of breast cancer-specific mortality (HR 1.00, 95% CI 0.97–1.03) compared to patients with BCa-1. However, when additionally controlling for tumor characteristics and treatment modes, BCa-2 patients were at an increased risk of breast cancer-specific mortality (HR 1.11, 95% CI 1.08–1.15). The risk elevation was particularly greater when the first malignancy was lung, bladder, ovarian or blood malignancy (HRs 1.16–1.85), or when the first malignancy was treated with chemotherapy and radiotherapy (HR 1.44, 95% CI 1.28–1.63). Overall, patients with BCa-2 have worse breast cancer-specific survival, compared with their BCa-1 counterparts, although the risk elevation is mild. High-risk subgroups based on first malignancy’s characteristics may be considered for active clinical management.
机译：作为第二个恶性肿瘤（BCA-2）发展乳腺癌的癌症幸存者是常见的。然而，与第一原发性乳腺癌（BCA-1）相比，对BCA-2的预后知之甚少。使用监视，流行病学和最终结果数据库，我们进行了一项基于人群的群组研究，包括1990 - 2015年的BCA-1和BCA-2患者的883,881名患者。与BCA-1患者相比，我们使用多变量COX回归计算BCA-2患者患者患者患者患者特异性死亡率的危险比（HRS）。在随访期间（中位数5.5？年），分别在BCA-1和BCA-2患者中鉴定了114,964岁和3829乳腺癌的死亡。 BCA-2的患者具有更有利的肿瘤特性，并且接受了较少的密集治疗，例如，手术和化疗？/无线电治疗，与BCA-1患者相比。在调整人口因子时，与BCA-1患者相比，BCA-2患者患有乳腺癌特异性死亡率（HR 1.00,95％CI 0.97-1.03）的风险。然而，当另外控制肿瘤特征和治疗方式时，BCA-2患者的风险增加了乳腺癌特异性死亡率（HR 1.11,95％CI 1.08-1.15）。当第一次恶性肿瘤，膀胱，卵巢或血液恶性肿瘤（HRS 1.16-1.85）或者当第一次恶性肿瘤用化疗和放射治疗时（HR 1.44,95％CI 1.28-1.63）时，风险升高特别大。总体而言，与BCA-1对应物相比，BCA-2患者具有更差的乳腺癌癌症存活，尽管风险高程是温和的。基于第一次恶性肿瘤特征的高风险亚组可以考虑积极临床管理。

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