TY - JOUR
T1 - Survival of women diagnosed with breast cancer and who have survived a previous cancer
AU - Pruitt, Sandi L.
AU - Zhu, Hong
AU - Heitjan, Daniel F.
AU - Rahimi, Asal
AU - Maddineni, Bhumika
AU - Tavakkoli, Anna
AU - Halm, Ethan A.
AU - Gerber, David E.
AU - Xiong, Danyi
AU - Murphy, Caitlin C.
N1 - Funding Information:
This work was supported by the National Cancer Institute (NCI) (R01CA229834-02 to SLP and K24CA201543 to DEG).
Funding Information:
The authors also acknowledge the efforts of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database. Contents of this paper are solely the responsibility of the authors and do not necessarily represent the official view of the NIH.
Funding Information:
DH reports consulting for Braintree Labs, Creatics LLC, Abbott Labs, and Macrogenics, Inc., and legal consulting for Noven and Women’s Talc Project; AR reports consulting and advisory board for Hologic and research grant and educational speaker for Accuray; and DEG reports research funding from Astra-Zeneca, BerGenBio, and Karyopharm, Gilead stock ownership and consulting for Samsung Bioepis and Catalyst Pharmaceuticals. SLP, HZ, BM, DX, AT, EAH, and CCM have no disclosures.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
PY - 2021/6
Y1 - 2021/6
N2 - Purpose: Many women diagnosed with breast cancer have survived previous cancer; yet little is known about the impact of previous cancer on overall and cancer-specific survival. Methods: This population-based cohort study using SEER-Medicare data included women (age ≥ 66 years) diagnosed with breast cancer between 2005 and 2015. Separately by breast cancer stage, we estimated effect of previous cancer on overall survival using Cox regression and on cause-specific survival using competing risk regression; all survival analyses adjusted for covariates. Results: Of 138,576 women diagnosed with breast cancer, 8% had a previous cancer of another organ site, most commonly colorectal or uterine cancer or melanoma. Many of these women (46.3%) were diagnosed within 5 years of breast cancer. For all breast cancer stages except IV wherein there was no difference, women with vs. without previous cancer had worse overall survival. This survival disadvantage was driven by deaths due to the previous cancer and other causes. In contrast, women with previous cancer generally had favorable breast-cancer-specific survival, although this varied by stage. Overall survival varied by previous cancer type, timing, and stage; previous lung cancer, cancer diagnosed within 1 year of incident breast cancer, and previous cancer at a distant stage were associated with the worst survival. In contrast, women with a previous melanoma had equivalent overall survival to women without previous cancer. Conclusion: We observed variable impact of previous cancer on overall and breast-cancer-specific survival depending on breast cancer stage at diagnosis and the type, timing, and stage of previous cancer.
AB - Purpose: Many women diagnosed with breast cancer have survived previous cancer; yet little is known about the impact of previous cancer on overall and cancer-specific survival. Methods: This population-based cohort study using SEER-Medicare data included women (age ≥ 66 years) diagnosed with breast cancer between 2005 and 2015. Separately by breast cancer stage, we estimated effect of previous cancer on overall survival using Cox regression and on cause-specific survival using competing risk regression; all survival analyses adjusted for covariates. Results: Of 138,576 women diagnosed with breast cancer, 8% had a previous cancer of another organ site, most commonly colorectal or uterine cancer or melanoma. Many of these women (46.3%) were diagnosed within 5 years of breast cancer. For all breast cancer stages except IV wherein there was no difference, women with vs. without previous cancer had worse overall survival. This survival disadvantage was driven by deaths due to the previous cancer and other causes. In contrast, women with previous cancer generally had favorable breast-cancer-specific survival, although this varied by stage. Overall survival varied by previous cancer type, timing, and stage; previous lung cancer, cancer diagnosed within 1 year of incident breast cancer, and previous cancer at a distant stage were associated with the worst survival. In contrast, women with a previous melanoma had equivalent overall survival to women without previous cancer. Conclusion: We observed variable impact of previous cancer on overall and breast-cancer-specific survival depending on breast cancer stage at diagnosis and the type, timing, and stage of previous cancer.
KW - Breast cancer
KW - Clinical trial eligibility criteria
KW - Multiple primary malignancies
KW - Prior cancer
KW - Survival
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U2 - 10.1007/s10549-021-06122-w
DO - 10.1007/s10549-021-06122-w
M3 - Article
C2 - 33620590
AN - SCOPUS:85101324901
VL - 187
SP - 853
EP - 865
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
SN - 0167-6806
IS - 3
ER -