@article{3166845,
    title = "Risk of second primary malignancies in women with breast cancer: Results
from the European prospective investigation into cancer and nutrition
(EPIC)",
    author = "Ricceri, Fulvio and Fasanelli, Francesca and Giraudo, Maria Teresa and and Sieri, Sabina and Tumino, Rosario and Mattiello, Amalia and Vagliano, and Liliana and Masala, Giovanna and Ramon Quiros, J. and Travier, Noemie and and Sanchez, Maria-Jose and Larranaga, Nerea and Chirlaque, and Maria-Dolores and Ardanaz, Eva and Tjonneland, Anne and Olsen, Anja and and Overvad, Kim and Chang-Claude, Jenny and Kaaks, Rudolf and Boeing, and Heiner and Clavel-Chapelon, Franc Oise and Kvaskoff, Marina and Dossus, and Laure and Trichopoulou, Antonia and Benetou, Vassiliki and Adarakis, and George and Bueno-de-Mesquita, H. B(As) and Peeters, Petra H. and Sund, and Malin and Andersson, Anne and Borgquist, Signe and Butt, Salma and and Weiderpass, Elisabete and Skeie, Guri and Khaw, Kay-Tee and Travis, Ruth and C. and Rinaldi, Sabina and Romieu, Isabelle and Gunter, Marc and Kadi, and Mai and Riboli, Elio and Vineis, Paolo and Sacerdote, Carlotta",
    journal = "International Journal  of Cancer",
    year = "2015",
    volume = "137",
    number = "4",
    pages = "940-948",
    publisher = "Wiley",
    issn = "0020-7136",
    doi = "10.1002/ijc.29462",
    keywords = "second primary tumours; breast cancer; Aalen-Johansen estimator; tumour
size",
    abstract = "Women with a diagnosis of breast cancer are at increased risk of second
primary cancers, and the identification of risk factors for the latter
may have clinical implications. We have followed-up for 11 years 10,045
women with invasive breast cancer from a European cohort, and identified
492 second primary cancers, including 140 contralateral breast cancers.
Expected and observed cases and Standardized Incidence Ratios (SIR) were
estimated using Aalen-Johansen Markovian methods. Information on various
risk factors was obtained from detailed questionnaires and
anthropometric measurements. Cox proportional hazards regression models
were used to estimate the role of risk factors. Women with breast cancer
had a 30% excess risk for second malignancies (95% confidence
interval-CI 18-42) after excluding contralateral breast cancers. Risk
was particularly elevated for colorectal cancer (SIR, 1.71, 95% CI
1.43-2.00), lymphoma (SIR 1.80, 95% CI 1.31-2.40), melanoma (2.12;
1.63-2.70), endometrium (2.18; 1.75-2.70) and kidney cancers (2.40;
1.57-3.52). Risk of second malignancies was positively associated with
age at first cancer, body mass index and smoking status, while it was
inversely associated with education, post-menopausal status and a
history of full-term pregnancy. We describe in a large cohort of women
with breast cancer a 30% excess of second primaries. Among risk factors
for breast cancer, a history of full-term pregnancy was inversely
associated with the risk of second primary cancer.
What’s new? For the first time, researchers have used cohort data to
show that people who survive breast cancer have a higher risk of
developing another cancer later. By collecting data on 10,000 breast
cancer patients over 11 years, these authors calculated a 30% boost in
the patients’ risk of developing a second primary malignancy,
particularly colorectal cancer, lymphoma, melanoma, endometrial cancer,
and kidney cancer. These findings, plus the data they collected on risk
factors such as age, smoking, body mass index, and others, will help
guide clinicians in screening procedures and follow up care for breast
cancer patients."
}