Breast Cancer Research and Treatment

, Volume 61, Issue 3, pp 183–195 | Cite as

Increased risk of second cancers following breast cancer: Role of the initial treatment

  • Carole Rubino
  • Florent de Vathaire
  • Ibrahima Diallo
  • Akhtar Shamsaldin
  • Monique G Lê


Objectives and methods.The risk of second primary malignancies (SMN) was studied in a cohort of 4,416 one-year survivors of a breast cancer. The role of the menopausal status and of the initial treatment modalities (surgery, radiotherapy, and chemotherapy) was investigated.

Results.Excluding second primary breast cancer and non-melanoma skin cancer, a total of 193 (4.4%) patients developed a SMN between 1973 and 1992, compared with 136 expected (Standardised Incidence Ratio, SIR = 1.4, 95% CI (1.2–1.6)). No trend towards either an increase or a decrease was noted in the SIR with time after treatment (p = 0.2). The greatest increase in the relative risk concerned soft tissue cancers (SIR = 13.0, 95% CI: 6.8–22.3), followed by leukaemia (SIR = 3.1, 95% CI: 1.7–5.0), melanoma (SIR  =  2.7, 95% CI: 1.4–4.8), kidney (SIR = 2.5, 95% CI: 1.2–4.5), ovary (SIR = 2.0, 95% CI: 1.2–3.1) and uterine tumours (SIR = 1.9, 95% CI: 1.4–2.5). The SIR was 3.0 (95% CI 1.8–4.7) in women under 40 at the time of the breast cancer, 1.9 (95% CI : 1.4 – 2.4) in those aged 40–49 and 1.2 (95% CI 1.0–1.4) in those aged 50 or more. In the 2,514 women who had received radiotherapy as initial treatment without chemotherapy, the SIR for all SMN was 1.6 (95% CI: 1.1–2.3) fold higher than in those who had not received radiotherapy as initial treatment.

Conclusion.In conclusion, this study confirms the increased risk of second malignancies in women treated for a breast cancer, and particularly in those who were younger at the time of treatment for breast cancer. Our results also suggest that radiotherapy may play a role in the onset of these second lesions.

breast cancer chemotherapy cohort study radiotherapy second primary cancer 


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Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Carole Rubino
    • 1
  • Florent de Vathaire
    • 1
  • Ibrahima Diallo
    • 1
    • 2
  • Akhtar Shamsaldin
    • 1
    • 2
  • Monique G Lê
    • 1
  1. 1.Institut Gustave RoussyUnité de Recherche en Epidemiologie des Cancers de l'Institut National de la Santé et de la Recherche Médicale (U521 INSERM)VillejuifFrance
  2. 2.Service de PhysiqueInstitut Gustave RoussyVillejuifFrance

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