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Breast Cancer Survivors Have 25 Percent Chance of
Cancer Somewhere Else
International study examines second cancers and
possible causes
Dec. 8, 2005 Women who have suffered from breast
cancer have a 25 percent greater risk than other women of developing a
new cancer somewhere else in their bodies. Researchers who conducted an
international study of over a half-million women with breast cancer also
analyzed the second cancers and possible causes.
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The study is published online today in the
International Journal of Cancer, the official journal of the
International Union Against Cancer (UICC), is available via Wiley
InterScience (click
here).
Breast cancer is the most common cancer among women
in developed countries. Due to the high five-year survival rate (77
percent), a considerable number of women have a long-term risk of
developing a second cancer.
Previous studies have also shown a 20-30 percent
increased risk for a second cancer in various sites, including the
endometrium, ovary, thyroid, lung, soft tissue, blood, skin, stomach and
colon, with higher risks among younger patients.
Researchers led by Lene Mellemkjζr of the Danish
Cancer Society in Copenhagen, Denmark conducted a huge study involving
525,527 patients with breast cancer in 13 cancer registries in Europe,
Canada, Australia and Singapore.
Records were analyzed for second primary cancers
during the period 1943 to 2000, with 133,414 women followed for more
than 10 years after the initial diagnosis of breast cancer. The
increased risk of a second cancer was seen in many different sites, as
shown in earlier studies.
"The excess of cancer after a breast cancer
diagnosis is likely to be explained by treatment for breast cancer and
by shared genetic or environmental risk factors although the general
excess of cancer suggests that there may be additional explanations such
as increased surveillance and general cancer susceptibility," the
authors note.
The study found an almost 6-fold increase in the
risk of cancer in connective tissue of the thorax and upper limbs, which
suggests that radiation therapy, which has been used to treat breast
cancer since the beginning of the 20th century, may play a role in
developing a second cancer in organs close to the breast.
An increased risk of myeloid leukemia was also
shown, possibly as a result of chemotherapy.
In addition, while previous studies had shown an
increased risk of endometrial cancer with the use of tamoxifen, the
current study suggests that this may not be entirely due to the drug,
since the increased risk was already shown within one year of breast
cancer diagnosis, it was shown before 1975 when tamoxifen was rarely
used, and an increased risk of breast cancer was also seen after
endometrial cancer.
Colorectal, kidney and postmenopausal breast cancer
appear to share obesity as a risk factor, while ovarian cancer and
breast cancer seem to have a genetic predisposition in common.
The study found an excess of ovarian cancer already
within one year of breast cancer diagnosis, along with an increased risk
of breast cancer after ovarian cancer.
"The overall impression from this very large study
is that a breast cancer diagnosis has an effect on subsequent cancer
risk in general, since so many cancer sites were seen to occur in excess
of what was expected," the authors conclude. "The known effects of
treatment and common risk factors do not seem to fully explain the
excesses."
About the Study
Article: "Risk of Second Cancer Among Women with Breast Cancer,"
Lene Mellemkjζr, Sψren Friis, Jψrgen H. Olsen, Ghislaine Scιlo, Kari
Hemminki, Elizabeth Tracey, Aage Andersen, David H. Brewster, Eero
Pukkala, Mary McBride, Erich V. Kliewer, Jon M. Tonita, Chia Kee-Seng,
Vera Pompe-Kirn, Carmen Martos, Jon G. Jonasson, Paolo Boffetta, Paul
Brennan, International Journal of Cancer, Published Online: December 8,
2005 (DOI: 10.1002/ijc.21651)
About the International Journal of Cancer
The International Journal of Cancer, the Official Journal of the
International Union Against Cancer (UICC), has long been established as
a leading publication for original papers and review articles on the
spectrum of topics germane to experimental and clinical cancer research.
The International Journal of Cancer concentrates on the fundamental
studies that have relevance to the understanding and effective treatment
of human cancer. This resource is distinctive for publishing
epidemiological studies from all over the world, to a magnitude not
instituted anywhere else in oncology-related literature.
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