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HR Status, Age Impact Risk for Subsequent Cancers in Breast Cancer Survivors

THURSDAY, May 20, 2021 -- Breast cancer survivors have a higher risk for subsequent primary cancers than the general population, and risk differs substantially by breast cancer subtype and age, according to a study published online May 18 in Cancer.

Hyuna Sung, Ph.D., from the American Cancer Society in Atlanta, and colleagues used data from Surveillance, Epidemiology, and End Results registries to identify 431,222 breast cancer survivors (at least one year) diagnosed between the ages of 20 and 84 years from 1992 to 2015. The analysis examined risks for subsequent primary cancers.

The researchers found that compared with the general population, the risk for new cancer diagnoses among survivors was higher for hormone receptor (HR)-positive cancers (standardized incidence ratio, 1.20; excess absolute risk, 23.3 per 10,000 person-years) and even higher for HR-negative cancers (standardized incidence ratio, 1.44; excess absolute risk, 45.2 per 10,000 person-years). The risk difference between HR statuses was statistically significant. Following HR-negative cancer, the higher risk was driven by acute nonlymphocytic leukemia and breast, ovarian, peritoneal, and lung cancers. The total excess absolute risk per 10,000 person-years ranged from 15.8 among late-onset (50 to 84 years) HR-positive survivors to 69.4 among early-onset (20 to 49 years) HR-negative survivors. Subsequent breast cancer accounted for 73 to 80 percent of the total excess absolute risk. The greatest excess absolute risks after breast cancer were for ovarian cancer among early-onset HR-negative survivors, lung cancer among early- and late-onset HR-negative survivors, and uterine corpus cancer among late-onset HR-positive survivors.

"Risks of subsequent primary cancers after breast cancer differ substantially by subtype and age," the authors write. "This suggests that more targeted approaches for cancer prevention and early-detection strategies are needed in survivorship care planning."

One author disclosed financial ties to UpToDate.

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