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Second primary cancers among females with a first primary breast cancer: a population-based study in Northern Portugal

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

To estimate the incidence rate of second primary cancers (SPCs) and the cumulative incidence of metachronous [diagnosed > 2 months after a first primary cancer (FPC)] SPCs in patients with a breast FPC, and to compare the incidence of SPC [overall, synchronous (≤ 2 months of the FPC) and metachronous] with that expected in the general female population.

Methods

A cohort of patients with a breast FPC from the North Region Cancer Registry of Portugal, diagnosed in 2000–2010 (n = 15,981), was followed to 31 December 2015 for synchronous and metachronous SPCs. Cumulative incidence of metachronous SPCs considering death as a competing event, and incidence rates and standardized incidence ratios of SPCs were estimated.

Results

The diagnosis of an SPC occurred in 1229 (7.7%) of patients with a breast FPC. SPCs occurred mainly in the breast, followed by digestive organs, lung, thyroid, and female genital organs. Globally, patients with a breast FPC had a higher incidence for all types of cancer compared to the general female population, and in particular for cancers of the breast, stomach, colon, lung, lymphoma, uterus, and ovary. The 10-year cumulative incidence of metachronous SPCs following a breast FPC was 6.6% and the corresponding 10-year cumulative mortality was 26.2%.

Conclusion

In Portugal, patients with a breast FPC have a higher incidence of cancer compared to the general female population, highlighting important aspects of care, surveillance, and counselling among this growing number of patients.

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Data availability

The data that support the findings of this study are available from RORENO, but restrictions apply to the availability of these data, which were used under license for the current study and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of RORENO.

Abbreviations

95%CI:

95% confidence interval

BCa:

Breast cancer

FPC:

First primary cancer

IACR:

International Association of Cancer Registries

IARC:

International Agency for Research on Cancer

NHL:

Non-Hodgkin lymphoma

P25-P75:

Percentile 25 – percentile 75

PYAR:

Person-years at risk

RORENO:

North Region Cancer Registry of Portugal

SIR:

Standardized incidence ratios

SPC:

Second primary cancer

US:

United States

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Funding

This study was funded by national funds from the Foundation for Science and Technology – FCT (Portuguese Ministry of Science, Technology and Higher Education), under the Unidade de Investigação em Epidemiologia – Instituto de Saúde Pública da Universidade do Porto (EPIUnit; UIDB/04750/2020) and the Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR; LA/P/0064/2020). SM was funded by FEDER through the Operational Program Competitiveness and Internationalization, and national funding from FCT under the scope of the project “NEON-PC - Neuro-oncological complications of prostate cancer: longitudinal study of cognitive decline” (POCI-01-0145-FEDER-032358; ref. PTDC/SAU-EPI/32358/2017) and the EPIUnit – Junior Research – Prog Financing (UIDP/04750/2020). The funding sources had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Author information

Authors and Affiliations

  1. EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal

    Elisabete Gonçalves, Filipa Fontes, Nuno Lunet & Samantha Morais

  2. Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal

    Elisabete Gonçalves, Filipa Fontes, Nuno Lunet & Samantha Morais

  3. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

    Filipa Fontes & Nuno Lunet

  4. Unidade de Investigação em Enfermagem Oncológica - Centro de Investigação (CI-IPOP), Instituto Português de Oncologia do Porto, Porto, Portugal

    Filipa Fontes

  5. Grupo de Investigação em Epidemiologia, Economia e Gestão em Oncologia - Centro de Investigação (CI-IPOP) & Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Rede de Investigação em Saúde), Instituto Português de Oncologia do Porto FG, EPE (IPO-Porto), Resultados, Porto, Portugal

    Jéssica Rocha Rodrigues, Rita Calisto & Maria José Bento

  6. Serviço de Epidemiologia, Instituto Português de Oncologia do Porto FG, EPE – Porto, Portugal

    Jéssica Rocha Rodrigues, Rita Calisto & Maria José Bento

  7. Departamento Estudos de Populações, Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal

    Maria José Bento

Authors
  1. Elisabete Gonçalves
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  7. Samantha Morais
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Contributions

All authors contributed to the study conception and design. Data preparation and collection were performed by Elisabete Gonçalves, Jéssica Rocha Rodrigues, Rita Calisto, Maria José Bento, and Samantha Morais. Analyses were performed by Elisabete Gonçalves and Samantha Morais. The first draft of the manuscript was written by Elisabete Gonçalves, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Samantha Morais.

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Ethics approval

The study was approved by the Ethics Committee of the Portuguese Institute of Oncology of Porto (Ref. CES IPO: 332/020) and the analyses were performed according to RORENO guidelines ensuring the anonymity of information used.

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The authors have no relevant financial or non-financial interests to disclose.

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Gonçalves, E., Fontes, F., Rodrigues, J.R. et al. Second primary cancers among females with a first primary breast cancer: a population-based study in Northern Portugal. Breast Cancer Res Treat 204, 367–376 (2024). https://doi.org/10.1007/s10549-023-07224-3

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