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Survival of Patients with First and Metachronous Second Primary Breast Cancer or Lung Cancer Malignancy: Comparisons Using the SEER Database



Breast cancer (BC) and lung cancer (LuC) are common malignancies. The survival of patients with metachronous second primary malignancy (MSPM) of BC and LuC after a first primary of BC and LuC remains unclear.


Data of patients with BC and LuC, with or without MSPM of BC and LuC, who were diagnosed from 2000 to 2014, were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The baseline characteristics of the different groups were compared using chi-square tests. The survival curves were compared using the log-rank test. Survival analysis was also performed in other malignancies with data extracted from the SEER database using the same method.


Significant differences in most of the demographics and clinicopathological factors were found between the groups. Patients with LuC with an MSPM of BC (LuC2BC) exhibited better survival than those with LuC (P < 0.001), while patients with BC with an MSPM of LuC (BC2LuC) exhibited worse survival than those with BC (P < 0.001). A similar trend was found in other malignancies. Prostate cancer (PC) followed by thyroid cancer (TC) (PC2TC) and TC followed by PC (TC2PC) did not show an obvious survival trend against their index malignancy (IM).


MSPM benefits the IM prognosis if the survival rate of MSPM is better than that of the IM and vice versa. However, the situation is somewhat confusing when the survival differences between MSPM and IM are minimal.

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We thank Prof. Yiping He from the Department of Pathology, Duke University Medical Center for critical revision of the manuscript.


Kefeng Lei was supported by a grant from the Natural Science Foundation of Zhejiang Province of China (grant number LY18H160039). The sponsor also partially funded the journal's Rapid Service Fee.

Editorial Assistance

This manuscript was edited for proper English language, grammar, punctuation, spelling, and overall style by Stefanie M. and Courey A. at American Journal Experts. This assistance was funded by the study sponsor.


All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.


Miaochun Zhong, Xianghong He, and Kefeng Lei have nothing to disclose.

Compliance with Ethics Guidelines

All SEER data were accessed with approval from the SEER database and, as such, this article does not contain any studies with human participants or animals performed by any of the authors.

Data Availability

The datasets analyzed in the current study are available from the corresponding author on reasonable request.

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Correspondence to Kefeng Lei.

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Zhong, M., He, X. & Lei, K. Survival of Patients with First and Metachronous Second Primary Breast Cancer or Lung Cancer Malignancy: Comparisons Using the SEER Database. Adv Ther 37, 2236–2245 (2020).

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  • Breast cancer
  • Lung cancer
  • Metachronous second primary malignancy
  • Oncology
  • SEER
  • Survival