Survival analysis for patients with metachronous contralateral breast cancer: Insights from a retrospective study

Park,Byeong-Kwan; Schneider,Jean; Suh,Young Jin

doi:10.3892/ol.2024.14523

Survival analysis for patients with metachronous contralateral breast cancer: Insights from a retrospective study

Authors:
- Byeong-Kwan Park
- Jean Schneider
- Young Jin Suh
View Affiliations

Affiliations: Division of Breast and Thyroid Surgical Oncology, Department of Surgery, The Catholic University of Korea St. Vincent's Hospital, Suwon, Gyeonggi 16247, Republic of Korea, School of Medicine, Texas Tech University Health Science Center, Lubbock, TX 79430, USA
Published online on: June 21, 2024 https://doi.org/10.3892/ol.2024.14523
Article Number: 390
Copyright: © Park et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Continued advances in the diagnosis and treatment of breast cancer (BC) have led to an increase in the number of long‑term BC survivors and an increase in the incidence of metachronous BC in the contralateral breast. Therefore, it is important to understand the factors that influence the development of metachronous BC; however, the impact of the laterality of the initial ipsilateral (I)BC as a risk factor for the development of metachronous contralateral (MC)BC has not been extensively investigated. The present study included 17,082 female patients with stage 0‑3 IBC from the prospectively maintained Korean Breast Cancer Registry from 1989‑2013 and divided them into two groups: Patients with MCBC (n=88) and those without MCBC (n=16,994). Risk factors that present at the initial BC diagnosis that could significantly influence the development of MCBC were screened for and risks were evaluated using the Fine‑Gray subdistribution hazard model. Significant differences in baseline characteristics between MCBC and non‑MCBC groups were demonstrated. Patients aged <40 years, those with histological and nuclear grade 3 tumors, and those with the triple‑negative BC subtype were significantly more prevalent in the MCBC group than in the non‑MCBC group. Additionally, the cumulative incidence of MCBC increased over time, with a notable increase from 0.1% in year 1 to 1.6% in year 10. Survival analysis revealed no significant differences in overall or BC‑specific survival between the two groups. Key predictive factors identified for MCBC included an age of <40 years at initial diagnosis, a negative progesterone receptor status, and a Ki‑67 score of >14%. Overall, the present study revealed several factors associated with MCBC and emphasized the need for long‑term monitoring of BC survivors, considering these newly identified risk factors.

View Figures

View References

1	Hartman M, Czene K, Reilly M, Adolfsson J, Bergh J, Adami HO, Dickman PW and Hall P: Incidence and prognosis of synchronous and metachronous bilateral breast cancer. J Clin Oncol. 25:4210–4216. 2007. View Article : Google Scholar : PubMed/NCBI
2	Nichols HB, Berrington de González A, Lacey JV Jr, Rosenberg PS and Anderson WF: Declining incidence of contralateral breast cancer in the United States from 1975 to 2006. J Clin Oncol. 29:1564–1569. 2011. View Article : Google Scholar : PubMed/NCBI
3	Rosen PP, Groshen S, Kinne DW and Hellman S: Contralateral breast carcinoma: An assessment of risk and prognosis in stage I (T1N0M0) and stage II (T1N1M0) patients with 20-year follow-up. Surgery. 106:904–910. 1989.PubMed/NCBI
4	Hankey BF, Curtis RE, Naughton MD, Boice JD Jr and Flannery JT: A retrospective cohort analysis of second breast cancer risk for primary breast cancer patients with an assessment of the effect of radiation therapy. J Natl Cancer Inst. 70:797–804. 1983.PubMed/NCBI
5	Reiner AS, John EM, Brooks JD, Lynch CF, Bernstein L, Mellemkjær L, Malone KE, Knight JA, Capanu M, Teraoka SN, et al: Risk of asynchronous contralateral breast cancer in noncarriers of BRCA1 and BRCA2 mutations with a family history of breast cancer: A report from the Women's environmental cancer and radiation epidemiology study. J Clin Oncol. 31:433–439. 2013. View Article : Google Scholar : PubMed/NCBI
6	Bernstein JL, Thompson WD, Risch N and Holford TR: Risk factors predicting the incidence of second primary breast cancer among women diagnosed with a first primary breast cancer. Am J Epidemiol. 136:925–936. 1992. View Article : Google Scholar : PubMed/NCBI
7	Bertelsen L, Bernstein L, Olsen JH, Mellemkjaer L, Haile RW, Lynch CF, Malone KE, Anton-Culver H, Christensen J, Langholz B, et al: Effect of systemic adjuvant treatment on risk for contralateral breast cancer in the Women's Environment, Cancer and Radiation Epidemiology Study. J Natl Cancer Inst. 100:32–40. 2008. View Article : Google Scholar : PubMed/NCBI
8	Early Breast Cancer Trialists' Collaborative Group (EBCTCG), : Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: An overview of the randomised trials. Lancet. 365:1687–1717. 2005. View Article : Google Scholar : PubMed/NCBI
9	Davies C, Pan H, Godwin J, Gray R, Arriagada R, Raina V, Abraham M, Medeiros Alencar VH, Badran A, Bonfill X, et al: Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet. 381:805–816. 2013. View Article : Google Scholar : PubMed/NCBI
10	Kilgore AR: The incidence of cancer in the second breast: After radical removal of one breast for cancer. J Am Med Assoc. 77:454–457. 1921. View Article : Google Scholar
11	Haagensen CD and Rosato FE: Diseases of the breast. Ann Surg. 176:6901972. View Article : Google Scholar
12	Prior P and Waterhouse JA: Incidence of bilateral tumours in a population-based series of breast-cancer patients. I. Two approaches to an epidemiological analysis. Br J Cancer. 37:620–634. 1978. View Article : Google Scholar : PubMed/NCBI
13	Healey EA, Cook EF, Orav EJ, Schnitt SJ, Connolly JL and Harris JR: Contralateral breast cancer: Clinical characteristics and impact on prognosis. J Clin Oncol. 11:1545–1552. 1993. View Article : Google Scholar : PubMed/NCBI
14	Intra M, Rotmensz N, Viale G, Mariani L, Bonanni B, Mastropasqua MG, Galimberti V, Gennari R, Veronesi P, Colleoni M, et al: Clinicopathologic characteristics of 143 patients with synchronous bilateral invasive breast carcinomas treated in a single institution. Cancer. 101:905–912. 2004. View Article : Google Scholar : PubMed/NCBI
15	de la Rochefordiere A, Asselain B, Scholl S, Campana F, Ucla L, Vilcoq JR, Durand JC, Pouillart P and Fourquet A: Simultaneous bilateral breast carcinomas: A retrospective review of 149 cases. Int J Radiat Oncol Biol Phys. 30:35–41. 1994. View Article : Google Scholar : PubMed/NCBI
16	Al-Jurf AS, Jochimsen PR, Urdaneta LF and Scott DH: Factors influencing survival in bilateral breast cancer. J Surg Oncol. 16:343–348. 1981. View Article : Google Scholar : PubMed/NCBI
17	Heron DE, Komarnicky LT, Hyslop T, Schwartz GF and Mansfield CM: Bilateral breast carcinoma: Risk factors and outcomes for patients with synchronous and metachronous disease. Cancer. 88:2739–2750. 2000. View Article : Google Scholar : PubMed/NCBI
18	Quan G, Pommier SJ and Pommier RF: Incidence and outcomes of contralateral breast cancers. Am J Surg. 195:645–650; discussion 650. 2008. View Article : Google Scholar : PubMed/NCBI
19	Londero AP, Bernardi S, Bertozzi S, Angione V, Gentile G, Dri C, Minucci A, Caponnetto F and Petri R: Synchronous and metachronous breast malignancies: A cross-sectional retrospective study and review of the literature. Biomed Res Int. 2014:2507272014. View Article : Google Scholar : PubMed/NCBI
20	Begg CB, Ostrovnaya I, Geyer FC, Papanastasiou AD, Ng CKY, Sakr RA, Bernstein JL, Burke KA, King TA, Piscuoglio S, et al: Contralateral breast cancers: Independent cancers or metastases. Int J Cancer. 142:347–356. 2018. View Article : Google Scholar : PubMed/NCBI
21	Hamy AS, Abécassis J, Driouch K, Darrigues L, Vandenbogaert M, Laurent C, Zaccarini F, Sadacca B, Delomenie M, Laas E, et al: Evolution of synchronous female bilateral breast cancers and response to treatment. Nat Med. 29:646–655. 2023. View Article : Google Scholar : PubMed/NCBI
22	Al Saad S, Al Shenawi H, Almarabheh A, Al Shenawi N, Mohamed AI and Yaghan R: Is laterality in breast Cancer still worth studying? Local experience in Bahrain. BMC Cancer. 22:9682022. View Article : Google Scholar : PubMed/NCBI
23	Abdou Y, Gupta M, Asaoka M, Attwood K, Mateusz O, Gandhi S and Takabe K: Left sided breast cancer is associated with aggressive biology and worse outcomes than right sided breast cancer. Sci Rep. 12:133772022. View Article : Google Scholar : PubMed/NCBI
24	Edge SB and Compton CC: The American Joint Committee on Cancer: The 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 17:1471–1474. 2010. View Article : Google Scholar : PubMed/NCBI
25	Wolff AC, Somerfield MR, Dowsett M, Hammond MEH, Hayes DF, McShane LM, Saphner TJ, Spears PA and Allison KH: Human epidermal growth factor receptor 2 testing in breast cancer: ASCO-college of american pathologists guideline update. J Clin Oncol. 41:3867–3872. 2023. View Article : Google Scholar : PubMed/NCBI
26	Song F, Li X, Song F, Zhao Y, Li H, Zheng H, Gao Z, Wang J, Zhang W and Chen K: Comparative genomic analysis reveals bilateral breast cancers are genetically independent. Oncotarget. 6:31820–31829. 2015. View Article : Google Scholar : PubMed/NCBI
27	Kim BK, Choi JE, Youn HJ, Park HS, Kim D, Oh SJ, Lee HJ, Lee J and Sun WY; Korean Breast Cancer Society, : Clinicopathological features and prognosis associated with breast cancer laterality: A nationwide study from the Korean Breast Cancer Society. Ann Surg Treat Res. 103:119–128. 2022. View Article : Google Scholar : PubMed/NCBI
28	Pan B, Xu Y, Zhou YD, Yao R, Wu HW, Zhu QL, Wang CJ, Mao F, Lin Y, Shen SJ and Sun Q: The prognostic comparison among unilateral, bilateral, synchronous bilateral, and metachronous bilateral breast cancer: A meta-analysis of studies from recent decade (2008–2018). Cancer Med. 8:2908–2918. 2019. View Article : Google Scholar : PubMed/NCBI
29	Kim H, Yoon TI, Kim S, Lee SB, Kim J, Chung IY, Ko BS, Lee JW, Son BH, Gwark S, et al: Survival after development of contralateral breast cancer in Korean patients with breast cancer. JAMA Netw Open. 6:e23335572023. View Article : Google Scholar : PubMed/NCBI
30	Austin PC and Fine JP: Practical recommendations for reporting Fine-Gray model analyses for competing risk data. Stat Med. 36:4391–4400. 2017. View Article : Google Scholar : PubMed/NCBI
31	Zhang Z: Survival analysis in the presence of competing risks. Ann Transl Med. 5:472017. View Article : Google Scholar : PubMed/NCBI
32	Broët P, de la Rochefordière A, Scholl SM, Fourquet A, Mosseri V, Durand JC, Pouillart P and Asselain B: Contralateral breast cancer: Annual incidence and risk parameters. J Clin Oncol. 13:1578–1583. 1995. View Article : Google Scholar : PubMed/NCBI
33	Gao X, Fisher SG and Emami B: Risk of second primary cancer in the contralateral breast in women treated for early-stage breast cancer: A population-based study. Int J Radiat Oncol Biol Phys. 56:1038–1045. 2003. View Article : Google Scholar : PubMed/NCBI