Risk of second primary malignancies in women with breast cancer: results from the European prospective investigation into cancer and nutrition (EPIC)

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Title: Risk of second primary malignancies in women with breast cancer: results from the European prospective investigation into cancer and nutrition (EPIC)
Authors: Ricceri, F
Fasanelli, F
Giraudo, MT
Sieri, S
Tumino, R
Mattiello, A
Vagliano, L
Masala, G
Ramon Quiros, J
Travier, N
Sanchez, M-J
Larranaga, N
Chirlaque, M-D
Ardanaz, E
Tjonneland, A
Olsen, A
Overvad, K
Chang-Claude, J
Kaaks, R
Boeing, H
Clavel-Chapelon, FO
Kvaskoff, M
Dossus, L
Trichopoulou, A
Benetou, V
Adarakis, G
Bueno-de-Mesquita, HBA
Peeters, PH
Sund, M
Andersson, A
Borgquist, S
Butt, S
Weiderpass, E
Skeie, G
Khaw, K-T
Travis, RC
Rinaldi, S
Romieu, I
Gunter, M
Kadi, M
Riboli, E
Vineis, P
Sacerdote, C
Item Type: Journal Article
Abstract: Women with a diagnosis of breast cancer are at increased risk of second primary cancers, and the identification of risk factors for the latter may have clinical implications. We have followed-up for 11 years 10,045 women with invasive breast cancer from a European cohort, and identified 492 second primary cancers, including 140 contralateral breast cancers. Expected and observed cases and Standardized Incidence Ratios (SIR) were estimated using Aalen-Johansen Markovian methods. Information on various risk factors was obtained from detailed questionnaires and anthropometric measurements. Cox proportional hazards regression models were used to estimate the role of risk factors. Women with breast cancer had a 30% excess risk for second malignancies (95% confidence interval—CI 18–42) after excluding contralateral breast cancers. Risk was particularly elevated for colorectal cancer (SIR, 1.71, 95% CI 1.43–2.00), lymphoma (SIR 1.80, 95% CI 1.31–2.40), melanoma (2.12; 1.63–2.70), endometrium (2.18; 1.75–2.70) and kidney cancers (2.40; 1.57–3.52). Risk of second malignancies was positively associated with age at first cancer, body mass index and smoking status, while it was inversely associated with education, post-menopausal status and a history of full-term pregnancy. We describe in a large cohort of women with breast cancer a 30% excess of second primaries. Among risk factors for breast cancer, a history of full-term pregnancy was inversely associated with the risk of second primary cancer.
Issue Date: 13-Feb-2015
Date of Acceptance: 12-Jan-2015
ISSN: 1097-0215
Publisher: Wiley
Start Page: 940
End Page: 948
Journal / Book Title: International Journal of Cancer
Volume: 137
Issue: 4
Copyright Statement: © 2015 UICC
Keywords: Science & Technology
Life Sciences & Biomedicine
second primary tumours
breast cancer
Aalen-Johansen estimator
tumour size
Age Factors
Body Mass Index
Breast Neoplasms
Follow-Up Studies
Middle Aged
Neoplasm Invasiveness
Neoplasms, Second Primary
Proportional Hazards Models
Risk Factors
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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