Messaggi chiave
- È stato condotto uno studio volto a valutare incidenza e timing di secondi tumori primitivi non di origine mammaria (SPNBC) in pazienti giovani sopravvissute a una diagnosi di carcinoma mammario (BC), insieme ai relativi fattori di rischio. L’analisi ha incluso 1230 partecipanti allo studio Young Women’s BC con diagnosi di BC in stadio 0-III ricevuta tra il 2006 e il 2016 ed età ≤40 anni all’esordio della malattia.
- Nell’arco di un follow-up mediano di 10,1 anni, il 4% delle pazienti ha sviluppato un SPNBC, compresi casi di melanoma, tumore della tiroide, carcinoma ovarico, sarcoma, tumore dell’utero, tumore rettale, tumore della vescica, carcinoma della cervice uterina, tumori del distretto testa-collo, tumore polmonare, linfoma, tumore pancreatico e carcinoma renale. L’incidenza cumulativa a 5 e 10 anni è risultata pari all’1,4 e 3,2%, rispettivamente, con un tempo mediano tra BC primario e SPNBC di 7,3 anni. Nessuna delle variabili prese in esame (correlate alla paziente, alla malattia o al trattamento) ha mostrato un’associazione significativa con il rischio di SPNBC nei modelli univariati e multivariati.
- Nella popolazione in studio, l’incidenza cumulativa a 5 anni di SPNBC è stata più alta di quanto riportato in donne sane sotto i 50 anni di età, a sottolineare l’importanza di una sorveglianza a lungo termine nelle pazienti giovani sopravvissute a BC.
Abstract
Purpose
- We evaluated the incidence, timing, and risk factors for second primary non-breast cancers (SPNBC) among young breast cancer (BC) survivors.
Methods
- This study included participants of the Young Women’s BC Study (YWS) who were diagnosed with stage 0-III BC between 2006 and 2016 and age 40 or younger at diagnosis (N = 1,230).
- Patient characteristics, treatment information, and clinical events were collected via serial surveys.
- Tumor and treatment data were obtained from medical record review.
- Five- and 10-year risks of SPNBCs were estimated via the cumulative incidence function, considering death, metastasis, or second primary BC as competing events.
- Fine and Gray subdistribution hazard models estimated subdistribution hazard ratios (sHRs) and 95% confidence intervals (CI) for SPNBC risk based on risk factors including demographics, germline genetics, primary BC characteristics, and treatments.
Results
- Among 1,230 women, over a median follow-up of 10.1 years, 47 patients (4%) developed an SPNBC.
- Types of malignancy included melanoma (n = 10), thyroid (n = 10), ovarian (n = 4), sarcoma (n = 4), uterine (n = 3), rectal (n = 3), bladder (n = 2), cervical (n = 2), head/neck (n = 2), lung (n = 2), lymphoma (n = 2), pancreatic (n = 2), and renal (n = 1).
- Five and 10-year cumulative incidence were 1.4 and 3.2%, respectively.
- Median time between primary BC and SPNBC was 7.3 years.
- No patient factors, primary tumor characteristics, or treatments were statistically significantly associated with SPNBC in univariable or multivariable models.
Conclusions
- In this population, five-year cumulative incidence was higher than that reported among healthy women under 50 years of age, highlighting the importance of long-term surveillance for new non-breast cancers in young adult BC survivors.