Population incidence and characteristics of secondary breast cancer after uterine cancer: a competing risk analysis
Population incidence and characteristics of secondary breast cancer after uterine cancer: a competing risk analysis
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子宫癌后继发性乳腺癌的人群发病率和特征：竞争风险分析
DOI：
10.1007/s00404-022-06440-4
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发表时间：
2022
影响因子：
2.6
通讯作者：
Wright Jason D.
中科院分区：
文献类型：
--
作者：
Matsuo Koji;Mandelbaum Rachel;Deshpande Rasika R.;Nusbaum David J.;Yoshihara Kosuke;Machida Hiroko;Bainvoll Liat;Matsuzaki Shinya;Klar Maximilian;Roman Lynda D.;Wright Jason D.
目的探讨子宫癌后继发乳腺癌的发生率及特点。方法：这是一项基于人群的回顾性队列研究，利用了1973年至2013年美国国家癌症研究所的监测、流行病学和最终结果项目。没有同步乳腺癌或乳腺癌病史的子宫癌妇女在诊断子宫癌后进行随访（N= 236,561）。一项时间依赖的竞争风险分析被用于检查那些随后发展为乳腺癌的患者的累积发病率和临床病理特征。结果子宫癌后继发乳腺癌7110例（3.0%），5年、10年、20年累计发病率分别为1.5、2.8、4.7%。继发性乳腺癌的发病率在子宫癌诊断后的前3年（年变化百分比[APC] 4.9）增加特别高，其次是诊断后的3 - 7年（APC 1.6） （P< 0.001）。发生继发性乳腺癌的中位时间为6.4年。年龄较大的女性诊断子宫癌和乳腺癌的时间间隔明显缩短（年龄为71岁的3.7年，64-71岁的5.9年，56 - 63岁的7.6年，年龄< 56岁的9.4年，P< 0.001）。在多变量分析中，年龄较大、白人、已婚、子宫内膜样、浆液性和混合组织学类型以及早期肿瘤仍然是继发性乳腺癌发生的独立因素（均P< 0.05）。结论子宫内膜样、浆液型及早期病变是子宫癌诊断后继发乳腺癌的相关因素。老年妇女发生继发性乳腺癌的时间较短。
PurposeTo examine incidence and characteristics of women who developed secondary breast cancer after uterine cancer.MethodsThis is a population-based retrospective cohort study utilizing the National Cancer Institute’s Surveillance, Epidemiology, and End Result Program from 1973 to 2013. Women with uterine cancer who did not have synchronous or a history of breast cancer were followed after their uterine cancer diagnosis (N= 236,561). A time-dependent competing risk analysis was performed to examine cumulative incidences and clinico-pathological characteristics of those who subsequently developed breast cancer.ResultsThere were 7110 (3.0%) women who developed secondary breast cancers after uterine cancer with 5-, 10-, and 20-year cumulative incidence rates of 1.5, 2.8, and 4.7%, respectively. The increase in the rate of secondary breast cancer was particularly high in the first 3 years after a uterine cancer diagnosis (annual percent change [APC] 4.9), followed by 3–7 years (APC 1.6) after diagnosis (P< 0.001). The median time to develop secondary breast cancer was 6.4 years. Older women had significantly shorter time intervals between uterine and breast cancer diagnoses (3.7 years for aged > 71, 5.9 for aged 64–71, 7.6 for aged 56–63, and 9.4 for aged < 56,P< 0.001). In a multivariable analysis, older age, White race, married status, endometrioid, serous, and mixed histology types, and early-stage tumors remained as independent factors of developing secondary breast cancer (all,P< 0.05).ConclusionTumor factors with endometrioid and serous histology types and early-stage disease were the factors associated with secondary breast cancer after uterine cancer diagnosis. Older women had shorter time to develop secondary breast cancer.