Risk Factors Affecting The Contralateral Breast Cancer after Treatment of Primary Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DENG Miao , WEI Jinqing , CHEN Dengting

The Third Department of General Surgery, The First Affiliated Hospital of Henan Technological and Scientific University, Luoyang 471003, Henan Province, China;

Corresponding author：

Keywords：

Contralateral breast cancer; Risk factor; Epidemiology; Endocrine therapy; Chemotherapy; Radiotherapy

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Objective To study the risk factors for contralateral breast cancer (CBC) in women after regular treatment of the primary breast cancer.
Methods Between January 1997 to December 2002, the clinical data of 340 breast cancer patients at our institution were retrospectively analyzed. In all the patients a detailed analysis was carried out with respect to age, operation type, radiation therapy technique and dose, the use of chemotherapy or hormone therapy, and other clinicopathologic characteristics. The KaplanMeier method was used to estimate the actuarial rate of CBC. The Cox proportional hazard regression model was used to estimate the relative risk factors of CBC.
Results Fourteen cases were diagnosed to be CBC, thus overall incidence of CBC was 4.1%. Ten-year CBC incidence (2.7%) was higher than 5-year incidence of CBC (1.4%). Univariate analysis showed that the risk factors of CBC at 5-year and 10-year included: ≤45 years old, medullary carcinoma, family history of breast cancer and being taken without endocrine therapy (P＜0.05), while chemotherapy and radiotherapy were not risk factors of CBC (P＞0.05). Mutivariate analysis showed that ≤ 45 years old and being internal breast radiotherapy were independent risk factors of CBC at 5-year and 10-year (P＜0.05).
Conclusions CBC may occur in these primary breast cancer patients with age ≤45 years old, medullary carcinoma, family history of breast cancer. In order to reduce the incidence of CBC, endocrine therapy rather than internal breast radiotherapy should be performed in early breast cancer patients.

Citation： DENG Miao,WEI Jinqing,CHEN Dengting. Risk Factors Affecting The Contralateral Breast Cancer after Treatment of Primary Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(7): 522-526. doi: Copy

1.	杨春明. 乳腺癌治疗的现代概念[Ｊ]. 中国普外基础与临床杂志, 2008; 15(17): 467470.
2.	Basco VE, Coldman AJ, Elwood JM, et al. Radiation dose and second breast cancer [Ｊ]. Br J Cancer, 1985; 52(3): 319325.
3.	Fowble B, Hanlon A, Freedman G, et al. Second cancers after conservative surgery and radiation for stages ⅠⅡ breast cancer: identifying a subset of women at increased risk [Ｊ]. Int J Radiat Oncol Biol Phys, 2001; 51(3): 679690.
4.	Brot P, de la Rochefordière A, Scholl SM, et al. Contralateral breast cancer: annual incidence and risk parameters [Ｊ]. J Clin Oncol, 1995; 13(7): 15781583.
5.	Unnithan J, Macklis RM. Contralateral breast cancer risk [Ｊ]. Radiother Oncol, 2001; 60(3): 239246.
6.	Silverman JS, Anderson P, Freedman G. Contralateral breast cancers within 5 years of conservative surgery and radiation: Implications for breast MRI [Ｊ]. Int J Radiat Oncol Biol Phys, 2007; 69(3): S211.
7.	Hermanek P, Sobin LH eds. TNM classification of malignant tumours [M]. 4th ed. Berlin New York: SpingerVerlag, 1987: 5658.
8.	田野. 乳腺癌放射治疗简介[Ｊ]. 实用临床医药杂志, 2008; 12(2): 3032.
9.	袁家宾, 林洋, 刘洪, 等. 早期乳腺癌保乳手术的疗效分析[Ｊ]. 中国普外基础与临床杂志, 2008; 15(7): 477478.
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11.	Chen Y, Thompson W, Semenciw R, et al. Epidemiology of contralateral breast cancer [Ｊ]. Cancer Epidemiol Biomarkers Prev, 1999; 8(10): 855861.
12.	Gao X, Fisher SG, Emami B. Risk of second primary cancer in the contralateral breast in women treated for earlystage breast cancer: a populationbased study[Ｊ]. Int J Radiat Oncol Biol Phys, 2003; 56(4): 10381041.
13.	Cook LS, White E, Schwartz SM, et al. A populationbased study of contralateral breast cancer following a first primary breast cancer (Washington United States) [Ｊ]. Cancer Causes Control, 1996; 7(3): 382390.
14.	MericBernstam F. High risk of contralateral breast carcinoma in women with hereditary/familial nonBRCA1/BRCA2 breast carcinoma [Ｊ]. Breast Diseases, 2007; 17(4): 340345.
15.	Storm HH, Andersson M, Boice JD Jr, et al. Adjuvant radiotherapy and risk of contralateral breast cancer[Ｊ]. J Natl Cancer Inst, 1992; 84(16): 12451250.
16.	Mertens WC, Hilbert V, MakariJudson G. Contralateral breast cancer: factors associated with stage and size at presentation[Ｊ]. Breast J, 2004; 10(4): 304312.
17.	Harvey EB, Brinton LA. Second cancer following cancer of the breast in Connecticut, 193582 [Ｊ]. Natl Cancer Inst Monogr, 1985; 68: 99103.
18.	Obedian E, Fischer B, Haffty BG. Second malignancies after treatment of earlystage breast cancer: lumpectomy and radiation therapy versus mastectomy [Ｊ]. J Clin Oncol, 2000; 18 (12): 24062412.
19.	Thierry Petit, 任国胜， Patrick Dufour，等. 乳腺癌辅助内分泌治疗 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(3): 248250.
20.	Brenner H, Siegle S, Stegmaier C, et al. Second primary neoplasms following breast cancer in Saarland, Germany, 19681987[Ｊ]. Eur J Cancer, 1993; 29A(10):　14101414.
21.	Early Breast Cancer Trialists Collaborative Group. Tamoxifen for early breast cancer: an overview of randomized trials[Ｊ]. Lancet, 1998; 351(9114):　14511467.
22.	杨金巧. 乳腺癌的内分泌治疗及研究进展 [Ｊ]. 中国普外基础与临床杂志, 2004;　11(1):　1214.
23.	Fisher B, Dignam J, Bryant J, et al. Five versus more than five years of tamoxifen for lymph nodenegative breast cancer: updated findings from the National Surgical Adjuvant Breast and Bowel Project B14 randomized trial [Ｊ]. J Natl Cancer Inst, 2001; 93(9): 684690.
24.	Kurtz JM, Amalric R, Brandone H, et al. Contralateral breast cancer and other second malignancies in patients treated by breastconserving therapy with radiation[Ｊ]. Int J Radiat Oncol Biol Phys,　1988; 15(2):　277284.
25.	Yadav BS, Sharma SC, Patel FD, et al. Second primary in the contralateral breast after treatment of breast cancer [Ｊ]. Radiother Oncol, 2008; 86(2): 171180.
26.	Fowble B, Hanlon A, Freedman G, et al. Internal mammary node irradiation neither decreases distant metastases nor improves survival in stage Ⅰ and Ⅱ breast cancer[Ｊ]. Int J Radiat Oncol Biol Phys, 2000； 47(4):　883894.

1. 杨春明. 乳腺癌治疗的现代概念[Ｊ]. 中国普外基础与临床杂志, 2008; 15(17): 467470.
2. Basco VE, Coldman AJ, Elwood JM, et al. Radiation dose and second breast cancer [Ｊ]. Br J Cancer, 1985; 52(3): 319325.
3. Fowble B, Hanlon A, Freedman G, et al. Second cancers after conservative surgery and radiation for stages ⅠⅡ breast cancer: identifying a subset of women at increased risk [Ｊ]. Int J Radiat Oncol Biol Phys, 2001; 51(3): 679690.
4. Brot P, de la Rochefordière A, Scholl SM, et al. Contralateral breast cancer: annual incidence and risk parameters [Ｊ]. J Clin Oncol, 1995; 13(7): 15781583.
5. Unnithan J, Macklis RM. Contralateral breast cancer risk [Ｊ]. Radiother Oncol, 2001; 60(3): 239246.
6. Silverman JS, Anderson P, Freedman G. Contralateral breast cancers within 5 years of conservative surgery and radiation: Implications for breast MRI [Ｊ]. Int J Radiat Oncol Biol Phys, 2007; 69(3): S211.
7. Hermanek P, Sobin LH eds. TNM classification of malignant tumours [M]. 4th ed. Berlin New York: SpingerVerlag, 1987: 5658.
8. 田野. 乳腺癌放射治疗简介[Ｊ]. 实用临床医药杂志, 2008; 12(2): 3032.
9. 袁家宾, 林洋, 刘洪, 等. 早期乳腺癌保乳手术的疗效分析[Ｊ]. 中国普外基础与临床杂志, 2008; 15(7): 477478.
10. Gralow J, Ozols RF, Bajorin DF, et al. Clinical cancer advances 2007: major research advances in cancer treatment, prevention, and screening—a report from the American Society of Clinical Oncology [Ｊ]. J Clin Oncol, 2008; 26(2): 313325.
11. Chen Y, Thompson W, Semenciw R, et al. Epidemiology of contralateral breast cancer [Ｊ]. Cancer Epidemiol Biomarkers Prev, 1999; 8(10): 855861.
12. Gao X, Fisher SG, Emami B. Risk of second primary cancer in the contralateral breast in women treated for earlystage breast cancer: a populationbased study[Ｊ]. Int J Radiat Oncol Biol Phys, 2003; 56(4): 10381041.
13. Cook LS, White E, Schwartz SM, et al. A populationbased study of contralateral breast cancer following a first primary breast cancer (Washington United States) [Ｊ]. Cancer Causes Control, 1996; 7(3): 382390.
14. MericBernstam F. High risk of contralateral breast carcinoma in women with hereditary/familial nonBRCA1/BRCA2 breast carcinoma [Ｊ]. Breast Diseases, 2007; 17(4): 340345.
15. Storm HH, Andersson M, Boice JD Jr, et al. Adjuvant radiotherapy and risk of contralateral breast cancer[Ｊ]. J Natl Cancer Inst, 1992; 84(16): 12451250.
16. Mertens WC, Hilbert V, MakariJudson G. Contralateral breast cancer: factors associated with stage and size at presentation[Ｊ]. Breast J, 2004; 10(4): 304312.
17. Harvey EB, Brinton LA. Second cancer following cancer of the breast in Connecticut, 193582 [Ｊ]. Natl Cancer Inst Monogr, 1985; 68: 99103.
18. Obedian E, Fischer B, Haffty BG. Second malignancies after treatment of earlystage breast cancer: lumpectomy and radiation therapy versus mastectomy [Ｊ]. J Clin Oncol, 2000; 18 (12): 24062412.
19. Thierry Petit, 任国胜， Patrick Dufour，等. 乳腺癌辅助内分泌治疗 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(3): 248250.
20. Brenner H, Siegle S, Stegmaier C, et al. Second primary neoplasms following breast cancer in Saarland, Germany, 19681987[Ｊ]. Eur J Cancer, 1993; 29A(10):　14101414.
21. Early Breast Cancer Trialists Collaborative Group. Tamoxifen for early breast cancer: an overview of randomized trials[Ｊ]. Lancet, 1998; 351(9114):　14511467.
22. 杨金巧. 乳腺癌的内分泌治疗及研究进展 [Ｊ]. 中国普外基础与临床杂志, 2004;　11(1):　1214.
23. Fisher B, Dignam J, Bryant J, et al. Five versus more than five years of tamoxifen for lymph nodenegative breast cancer: updated findings from the National Surgical Adjuvant Breast and Bowel Project B14 randomized trial [Ｊ]. J Natl Cancer Inst, 2001; 93(9): 684690.
24. Kurtz JM, Amalric R, Brandone H, et al. Contralateral breast cancer and other second malignancies in patients treated by breastconserving therapy with radiation[Ｊ]. Int J Radiat Oncol Biol Phys,　1988; 15(2):　277284.
25. Yadav BS, Sharma SC, Patel FD, et al. Second primary in the contralateral breast after treatment of breast cancer [Ｊ]. Radiother Oncol, 2008; 86(2): 171180.
26. Fowble B, Hanlon A, Freedman G, et al. Internal mammary node irradiation neither decreases distant metastases nor improves survival in stage Ⅰ and Ⅱ breast cancer[Ｊ]. Int J Radiat Oncol Biol Phys, 2000； 47(4):　883894.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Risk Factors Affecting The Contralateral Breast Cancer after Treatment of Primary Breast Cancer

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