Second Primary Breast Cancer Occurrence According to Hormone Receptor Status
Second Primary Breast Cancer Occurrence According to Hormone Receptor Status
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DOI：
10.1093/jnci/djp181
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发表时间：
2009-08-05
影响因子：
10.3
通讯作者：
Clarke, Christina A.
中科院分区：
文献类型：
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作者：
Kurian, Allison W.;McClure, Laura A.;Clarke, Christina A.
4%的女性乳腺癌幸存者发生侧第二原发性乳腺癌。关于与雌激素和孕激素受体相关的第二原发性乳腺癌风险的差异知之甚少我们计算了1992年1月1日至2004年12月31日期间诊断为首次乳腺癌的4927名女性中对侧原发性乳腺癌的标准化发病率（SIR）和95%置信区间（CI），使用美国国家癌症研究所的监测、流行病学和最终结果数据库，与一般人群相比，对于首次乳腺肿瘤HR阳性的女性，经年龄、种族和日历年调整后，患对侧原发性乳腺癌的风险升高（SIR = 2.22，95% CI = 2.15 - 2.29，绝对风险[AR] = 13例/10 000人-年[PY]），与第二个肿瘤的HR状态无关。对于首次乳腺肿瘤HR阴性的女性，对侧原发肿瘤的风险在统计学上显著高于首次肿瘤HR阳性的女性（SIR = 3.57，95% CI = 3.38 - 3.78，AR = 18/10 000 PY），并且它与HR阴性的第二肿瘤的可能性更大有关（HR阳性继发性肿瘤的SIR = 1.94，95% CI = 1.77 - 2.13，AR = 20/10 000 PY; HR阴性继发性肿瘤的SIR = 9.81，95% CI = 9.00 - 10.7，AR = 24/10 000 PY）。与一般人群相比，在年龄小于30岁时首次诊断为HR阴性肿瘤的女性发生HR阴性对侧肿瘤的风险显著升高（SIR = 169，95% CI = 106 - 256，AR = 77/10 000 PY）。非西班牙裔黑人、西班牙裔美国人、亚洲人或太平洋岛民中HR阴性或HR阳性肿瘤后对侧原发性乳腺癌的发病率高于非西班牙裔白人。对侧第二原发性乳腺癌的风险因第一肿瘤的HR状态、年龄、人种和/或种族而有很大差异。与一般人群相比，患有HR阴性第一肿瘤的女性发生HR阴性第二肿瘤的风险增加了近10倍。这些发现保证了对HR阴性肿瘤妇女的第二乳腺癌的密切监测。
Contralateral second primary breast cancers occur in 4% of female breast cancer survivors. Little is known about differences in risk for second primary breast cancers related to the estrogen and progesterone receptor (hormone receptor [HR]) status of the first tumor.We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for contralateral primary breast cancers among 4927 women diagnosed with a first breast cancer between January 1, 1992, and December 31, 2004, using the National Cancer Institute's Surveillance, Epidemiology, and End Results database.For women whose first breast tumors were HR positive, risk of contralateral primary breast cancer was elevated, compared with the general population, adjusted for age, race, and calendar year (SIR = 2.22, 95% CI = 2.15 to 2.29, absolute risk [AR] = 13 cases per 10 000 person-years [PY]), and was not related to the HR status of the second tumor. For women whose first breast tumors were HR negative, the risk of a contralateral primary tumor was statistically significantly higher than that for women whose first tumors were HR positive (SIR = 3.57, 95% CI = 3.38 to 3.78, AR = 18 per 10 000 PY), and it was associated with a much greater likelihood of an HR-negative second tumor (SIR for HR-positive second tumors = 1.94, 95% CI = 1.77 to 2.13, AR = 20 per 10 000 PY; SIR for HR-negative second tumors = 9.81, 95% CI = 9.00 to 10.7, AR = 24 per 10 000 PY). Women who were initially diagnosed with HR-negative tumors when younger than 30 years had greatly elevated risk of HR-negative contralateral tumors, compared with the general population (SIR = 169, 95% CI = 106 to 256, AR = 77 per 10 000 PY). Incidence rates for any contralateral primary cancer following an HR-negative or HR-positive tumor were higher in non-Hispanic blacks, Hispanics, and Asians or Pacific Islanders than in non-Hispanic whites.Risk for contralateral second primary breast cancers varies substantially by HR status of the first tumor, age, and race and/or ethnicity. Women with HR-negative first tumors have nearly a 10-fold elevated risk of developing HR-negative second tumors, compared with the general population. These findings warrant intensive surveillance for second breast cancers in women with HR-negative tumors.