Cargando…

The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: a population based study in the Netherlands

Background The impact of age and adjuvant therapy on contralateral breast cancer (CBC) risk and prognostic significance of CBC were evaluated. Patients and Methods In 45,229 surgically treated stage I–IIIA patients diagnosed in the Netherlands between 1989 and 2002 CBC risk was quantified using stan...

Descripción completa

Detalles Bibliográficos
Autores principales: Schaapveld, Michael, Visser, Otto, Louwman, W. J., Willemse, Pax H. B., de Vries, Elisabeth G. E., van der Graaf, Winette T. A., Otter, Renée, Coebergh, Jan Willem W., van Leeuwen, Flora E.
Formato: Texto
Lenguaje:English
Publicado: Springer US 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440941/
https://www.ncbi.nlm.nih.gov/pubmed/17687645
http://dx.doi.org/10.1007/s10549-007-9709-2
_version_ 1782156590140358656
author Schaapveld, Michael
Visser, Otto
Louwman, W. J.
Willemse, Pax H. B.
de Vries, Elisabeth G. E.
van der Graaf, Winette T. A.
Otter, Renée
Coebergh, Jan Willem W.
van Leeuwen, Flora E.
author_facet Schaapveld, Michael
Visser, Otto
Louwman, W. J.
Willemse, Pax H. B.
de Vries, Elisabeth G. E.
van der Graaf, Winette T. A.
Otter, Renée
Coebergh, Jan Willem W.
van Leeuwen, Flora E.
author_sort Schaapveld, Michael
collection PubMed
description Background The impact of age and adjuvant therapy on contralateral breast cancer (CBC) risk and prognostic significance of CBC were evaluated. Patients and Methods In 45,229 surgically treated stage I–IIIA patients diagnosed in the Netherlands between 1989 and 2002 CBC risk was quantified using standardised incidence ratios (SIRs), cumulative incidence and Cox regression analysis, adjusted for competing risks. Results Median follow-up was 5.8 years, in which 624 CBC occurred <6 months after the index cancer (synchronous) and 1,477 thereafter (metachronous). Older age and lobular histology were associated with increased synchronous CBC risk. Standardised incidence ratio (SIR) of CBC was 2.5 (95% confidence interval (95% CI) 2.4–2.7). The SIR of metachronous CBC decreased with index cancer age, from 11.4 (95% CI 8.6–14.8) when <35 to 1.5 (95% CI 1.4–1.7) for ≥60 years. The absolute excess risk of metachronous CBC was 26.8/10,000 person-years. The cumulative incidence increased with 0.4% per year, reaching 5.9% after 15 years. Adjuvant hormonal (Hazard rate ratio (HR) 0.58; 95% CI 0.48–0.69) and chemotherapy (HR 0.73; 95% CI 0.60–0.90) were associated with a markedly decreased CBC risk. A metachronous CBC worsened survival (HR 1.44; 95% CI 1.33–1.56). Conclusion Young breast cancer patients experience high synchronous and metachronous CBC risk. Adjuvant hormonal or chemotherapy considerably reduced the risk of CBC. CBC occurrence adversely affects prognosis, emphasizing the necessity of long-term surveillance directed at early CBC-detection.
format Text
id pubmed-2440941
institution National Center for Biotechnology Information
language English
publishDate 2007
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-24409412008-06-27 The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: a population based study in the Netherlands Schaapveld, Michael Visser, Otto Louwman, W. J. Willemse, Pax H. B. de Vries, Elisabeth G. E. van der Graaf, Winette T. A. Otter, Renée Coebergh, Jan Willem W. van Leeuwen, Flora E. Breast Cancer Res Treat Epidemiology Background The impact of age and adjuvant therapy on contralateral breast cancer (CBC) risk and prognostic significance of CBC were evaluated. Patients and Methods In 45,229 surgically treated stage I–IIIA patients diagnosed in the Netherlands between 1989 and 2002 CBC risk was quantified using standardised incidence ratios (SIRs), cumulative incidence and Cox regression analysis, adjusted for competing risks. Results Median follow-up was 5.8 years, in which 624 CBC occurred <6 months after the index cancer (synchronous) and 1,477 thereafter (metachronous). Older age and lobular histology were associated with increased synchronous CBC risk. Standardised incidence ratio (SIR) of CBC was 2.5 (95% confidence interval (95% CI) 2.4–2.7). The SIR of metachronous CBC decreased with index cancer age, from 11.4 (95% CI 8.6–14.8) when <35 to 1.5 (95% CI 1.4–1.7) for ≥60 years. The absolute excess risk of metachronous CBC was 26.8/10,000 person-years. The cumulative incidence increased with 0.4% per year, reaching 5.9% after 15 years. Adjuvant hormonal (Hazard rate ratio (HR) 0.58; 95% CI 0.48–0.69) and chemotherapy (HR 0.73; 95% CI 0.60–0.90) were associated with a markedly decreased CBC risk. A metachronous CBC worsened survival (HR 1.44; 95% CI 1.33–1.56). Conclusion Young breast cancer patients experience high synchronous and metachronous CBC risk. Adjuvant hormonal or chemotherapy considerably reduced the risk of CBC. CBC occurrence adversely affects prognosis, emphasizing the necessity of long-term surveillance directed at early CBC-detection. Springer US 2007-08-09 2008-07 /pmc/articles/PMC2440941/ /pubmed/17687645 http://dx.doi.org/10.1007/s10549-007-9709-2 Text en © Springer Science+Business Media, LLC 2007
spellingShingle Epidemiology
Schaapveld, Michael
Visser, Otto
Louwman, W. J.
Willemse, Pax H. B.
de Vries, Elisabeth G. E.
van der Graaf, Winette T. A.
Otter, Renée
Coebergh, Jan Willem W.
van Leeuwen, Flora E.
The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: a population based study in the Netherlands
title The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: a population based study in the Netherlands
title_full The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: a population based study in the Netherlands
title_fullStr The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: a population based study in the Netherlands
title_full_unstemmed The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: a population based study in the Netherlands
title_short The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: a population based study in the Netherlands
title_sort impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: a population based study in the netherlands
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440941/
https://www.ncbi.nlm.nih.gov/pubmed/17687645
http://dx.doi.org/10.1007/s10549-007-9709-2
work_keys_str_mv AT schaapveldmichael theimpactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT visserotto theimpactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT louwmanwj theimpactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT willemsepaxhb theimpactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT devrieselisabethge theimpactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT vandergraafwinetteta theimpactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT otterrenee theimpactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT coeberghjanwillemw theimpactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT vanleeuwenflorae theimpactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT schaapveldmichael impactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT visserotto impactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT louwmanwj impactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT willemsepaxhb impactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT devrieselisabethge impactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT vandergraafwinetteta impactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT otterrenee impactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT coeberghjanwillemw impactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands
AT vanleeuwenflorae impactofadjuvanttherapyoncontralateralbreastcancerriskandtheprognosticsignificanceofcontralateralbreastcancerapopulationbasedstudyinthenetherlands