Risk of secondary malignancies in non-Hodgkin lymphoma survivors: 40 years of follow-up assessed by treatment modality.

e19525 Background: Survivors of non-Hodgkin lymphoma (NHL) are at increased risk of secondary malignancies (SM). We quantified this risk in survivors with over 40 years of follow-up, and evaluated differences in risk by treatment modality. Methods: Standardized incidence ratios (SIR, observed-to-expected [O/E] ratio), which accounts for patient years at risk, and absolute excess risk of SM were assessed in 142,837 patients diagnosed with NHL as a first malignancy between 1975 and 2016 in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Follow up was available through 2016. Non-melanoma skin cancers were not counted as SM. SIRs were also evaluated for patients stratified by age at and latency from diagnosis. Results: In all, 14,101 patients received radiotherapy alone (RT), 68,424 received chemotherapy alone (CT), and 18,339 received chemotherapy and radiation (CRT). In total, 15,979 patients (11%) developed SM, more than the endemic rate (O/E 1.29; P < .01). Overall, patients treated with any RT (RT+CRT) had a similar risk of SM as those who did not receive RT (O/E 1.29 for both compared to endemic rate). Patients treated with RT had more risk of female breast cancer and less risk of leukemia than unirradiated patients (P < .05). Patients treated with any CT (CT+CRT) had increased SM rates compared with those who did not receive CT [O/E 1.33 (95% CI 1.30-1.35) vs 1.24 (95% CI 1.21-1.26), respectively], which included increased risks of leukemia, Kaposi sarcoma, kidney, pancreas, rectal, head and neck, and colon cancers and decreased risk of prostate cancer (P < 0.05). When stratified by four treatment groups (no CT or RT, RT alone, CT alone, CRT), there were no differences in SM rates between the no therapy and RT alone groups (O/E 1.24 95% CI 1.21-1.27 and O/E 1.23 95% CI 1.18-1.28 respectively). CT alone and CRT were associated with increased risk of secondary malignancy compared to the no therapy group (O/E 1.32 95% CI 1.29-1.35 and O/E 1.35 95% CI 1.29-1.40 respectively). CT alone was also associated with increased risk of leukemia, Kaposi sarcoma, kidney, head and neck and thyroid cancers, and a decreased risk of prostate cancer (P < .05). CRT was associated with increased risk of head and neck and female breast cancers (P < .05). There was no difference in the overall risk of SM between the CT alone and CRT groups and female breast cancer was the only site at which CRT was associated with higher risk than CT alone. Of note, female breast cancer risk was highest in those diagnosed under 25 years of age and at latencies of greater than 10 years. Conclusions: This is the largest study to examine secondary malignancy risk in patients with NHL and has the longest follow-up. Patients treated with RT alone did not have an increased SM risk compared to those who received no RT or CT. The risk of SMs was increased overall for NHL survivors and varied with treatment modality.

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Evaluation of the delivery of survivorship care plans for South Asian female breast cancer survivors residing in Canada

Current Oncology ◽

10.3747/co.25.3734 ◽

2018 ◽

Vol 25 (4) ◽

Cited By ~ 2

Author(s):

S. Singh-Carlson ◽

F. Wong ◽

G. Oshan

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

South Asian ◽

Breast Cancer Survivors ◽

Family Members ◽

Female Breast Cancer ◽

Post Treatment ◽

Survivorship Care ◽

Female Breast

Background This paper focuses on phase iii of a study evaluating the development and implementation of a survivorship care plan (scp) that could ultimately improve post-treatment quality of life for South Asian (sa) breast cancer survivors (bcss). Evaluating the utility of the scp was important to understand how sociocultural influences might affect uptake of the scp by sa bcss, especially as they transition from treatment to community care.Methods Post-treatment discharge planning using an individualized scp at discharge for sa female breast cancer patients with stage i or ii disease was offered as a pilot service to oncologists at BC Cancer’s Fraser Valley and Abbotsford centres. A longitudinal study using a mixed-methods approach was used to evaluate the utility of that service at 1 year after discharge.Results Participants (n = 16) completed a survey about their scp delivery experience, and a 1-year post implementation survey about the scp content and its utility. Most participants reported the discharge appointments to be extremely or very helpful with respect to post-treatment care questions. All have visited their family physicians for follow-up as recommended. The three major sources of support were family, faith, and family physician. Qualitative responses from the health care professionals who developed or implemented the scps identified two challenges in scp delivery: engaging patients or family members in relationship, and translating key information through interpreters.Conclusions It is important to evaluate the utility of scps for sa female survivors, who might differ from the general bcs population because of a different understanding of the disease; language barriers; strong influence of family members; societal stigmas; and personal, social, cultural, and religious beliefs and values. A formal nurse-led discharge appointment with discussions about follow-up care and an individualized scp outlining the short- and long-term effects of treatment are recommended. Particular attention has to be paid to the practical and psychosocial needs of sa bcss and their supporting family members.

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Prognostic Impact of BRCA1 and BRCA2 Mutations on Long-Term Survival Outcomes in Egyptian Female Breast Cancer Patients

Biology ◽

10.3390/biology10070566 ◽

2021 ◽

Vol 10 (7) ◽

pp. 566

Author(s):

Sherihan AbdelHamid ◽

Hala El-Mesallamy ◽

Hany Abdel Aziz ◽

Abdel-Rahman Zekri

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Female Breast Cancer ◽

Breast Cancer Patients ◽

Free Survival ◽

Female Breast ◽

Mutation Carriers ◽

Clinical Records

Evidence on the prognostic relevance of BRCA1/2 mutations on breast cancer survival is still debatable. To address this ambiguity, we sought to elucidate the impact of BRCA1/2 mutation carriership on long-term clinical outcomes for the first time in Egyptian female breast cancer patients. This study comprised 103 Egyptian female breast cancer patients previously tested for BRCA1/2 mutations. Clinicopathological characteristics and long-term follow-up data were retrieved from clinical records until death or loss to follow-up. Overall survival (OS), recurrence-free survival (RFS), disease-free survival (DFS), and metastasis-free survival (MFS) were compared in BRCA1/2 mutation carriers and non-carriers. Pathogenic variants (Class 5 according to ACMG/AMP guidelines) were observed in 29 cases. The profile of the detected variants was previously reported. After median follow-up time of 6.9 years (range, 4.2–24.4 years), BRCA1/2 carriers exhibited significantly worse RFS compared to non-carriers (p = 0.01; HR = 3.00 (95%CI 1.35–6.68)). However, we couldn’t demonstrate statistically significant difference between carriers of pathogenic mutations and non-carriers regarding MFS (p = 0.24; HR = 1.38 (95%CI 0.8–2.4)), DFS (p = 0.11; HR = 1.23 (95%CI 0.74–2.06)), or OS (p = 0.36; HR = 1.23 (95%CI 0.58–2.61)). Though no significant impact was observed in OS, yet BRCA1/2 mutation carriers were at high risk of recurrence, highlighting the importance of adopting BRCA screening strategies and prophylactic measures.

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Increased Risk of Cardiovascular Death in Breast Cancer Patients Without Chemotherapy or (and) Radiotherapy: A Large Population-Based Study

Frontiers in Oncology ◽

10.3389/fonc.2020.619622 ◽

2021 ◽

Vol 10 ◽

Author(s):

Tianwang Guan ◽

Hanbin Zhang ◽

Jinming Yang ◽

Wenrui Lin ◽

Kenie Wang ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Tumor Resection ◽

Cardiovascular Death ◽

Female Breast Cancer ◽

Breast Cancer Patients ◽

Cvd Risk ◽

Female Breast ◽

Increased Risk ◽

The Impact

BackgroundCardiovascular death (CVD) in breast cancer patients without chemotherapy (CT) or (and) radiotherapy (RT) has not been studied yet. This study evaluates the correlation between breast cancer and CVD risk independent of chemotherapy or (and) radiotherapy.MethodsData of female breast cancer patients without receiving CT or RT were retrieved from the Surveillance, Epidemiology, and End Result (SEER) database (2004–2015). Data were divided into two cohorts: tumor resection cohort and no resection cohort. The CVD risk in patients was expressed as standardized mortality ratios (SMRs). A 1:1 propensity score matching (PSM) was applied to balance inter-group bias, and competing risk regressions were utilized to evaluate the impact of tumor resection on CVD.ResultsThe CVD risk was significantly higher (SMR = 2.196, 95% CI: 2.148–2.245, P<0.001) in breast cancer patients who did not receive CT or RT compared to the general population. Breast cancer patients without tumor resection showed higher CVD risk than patients who underwent tumour resection (tumor resection SMR = 2.031, 95% CI: 1.983–2.079, P<0.001; no resection SMR = 5.425, 95% CI: 5.087–5.781, P<0.001). After PSM, the CVD risk among patients without tumor resection indicated an increase of 1.165-fold compared to patients with tumor resection (HR=1.165, 95% CI: 1.039–1.306, P=0.009).ConclusionsFemale breast cancer patients are at higher risk of CVD despite unexposure to cardio-toxic CT or RT. However, female breast cancer patients subjected to tumor resection have decreased CVD risk. These results indicated that monitoring female breast cancer patients not receiving RT or CT might serve as a preventative measure against CVD.

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Prognostic Factors after 5 Years Follow-Up in Female Breast Cancer

Oncology ◽

10.1159/000227019 ◽

1992 ◽

Vol 49 (2) ◽

pp. 93-98 ◽

Cited By ~ 17

Author(s):

S. Aaltomaa ◽

P. Lipponen ◽

M. Eskelinen ◽

V.-M. Kosma ◽

S. Marin ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Female Breast Cancer ◽

Female Breast

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Type 2 Diabetes and Risk of Incident Cancer in China: A Prospective Study Among 0.5 Million Chinese Adults

American Journal of Epidemiology ◽

10.1093/aje/kwx376 ◽

2018 ◽

Vol 187 (7) ◽

pp. 1380-1391 ◽

Cited By ~ 9

Author(s):

Xiong-Fei Pan ◽

Meian He ◽

Canqing Yu ◽

Jun Lv ◽

Yu Guo ◽

...

Keyword(s):

Breast Cancer ◽

Type 2 Diabetes ◽

Liver Cancer ◽

Female Breast Cancer ◽

Chinese Adults ◽

Female Breast ◽

Incident Cancer ◽

Increased Risk ◽

Total Cancer

Abstract Using data from the China Kadoorie Biobank Study, we conducted a prospective investigation on the association between type 2 diabetes mellitus (T2DM) and cancer risk in Chinese adults. A total of 508,892 participants (mean age = 51.5 (standard deviation, 10.7) years) without prior cancer diagnosis at baseline (2004–2008) were included. We documented 17,463 incident cancer cases during follow-up through December 31, 2013. Participants with T2DM had increased risks of total and certain site-specific cancers; hazard ratios were 1.13 (95% confidence interval (CI): 1.07, 1.19) for total cancer, 1.51 (95% CI: 1.29, 1.76) for liver cancer, 1.86 (95% CI: 1.43, 2.41) for pancreatic cancer, and 1.21 (95% CI: 1.01, 1.47) for female breast cancer. The associations were largely consistent when physician-diagnosed and screen-detected T2DM were analyzed separately, except for colorectal cancer (for physician-diagnosed T2DM, HR = 0.91 (95% CI: 0.73, 1.13), and for screen-detected T2DM, HR = 1.44 (95% CI: 1.18, 1.77)). In participants without a prior diagnosis of T2DM, higher random blood glucose levels were positively associated with risks of total cancer, liver cancer, and female breast cancer (all P’s for trend ≤ 0.02). In conclusion, T2DM is associated with an increased risk of new-onset cancer in China, particularly cancers of the liver, pancreas, and female breast.

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Frequency and Risk Factors for Post Mastectomy Pain Syndrome [PMPS] in Female Breast Cancer patients

10.53350/pjmhs2115102530 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2530-2533

Author(s):

Said Zaman Khan ◽

Sabih Nofil ◽

Anum Arif ◽

Maria Mir Jan ◽

Bismah Riaz ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Neuropathic Pain ◽

Pain Syndrome ◽

Female Breast Cancer ◽

Breast Cancer Patients ◽

Inclusion Criteria ◽

Female Breast ◽

Postoperative Risk

Post mastectomy pain syndrome is one of the most common complications after axillary surgery for breast cancer. PMPS is considered a neuropathic pain and is thought to be caused by a variety of pre-operative, intraoperative and postoperative risk factors. In this study all post operative patients for breast cancer were interviewed at follow-up visits for symptoms of pain according to DN4 neuropathic pain score questionnaire and VAS scale for pain intensity. A total of 97 patients were included according to inclusion criteria. Among them 24(24.74%) patients were having PMPS and 73(77.06%) were having no PMPS. Among risk factors, ALND was found to be the most important risk factor for development of PMPS. In most patients the pain was mild in intensity according to VAS scale. And site of the pain was mostly found to be ipsilateral chest wall and axilla and majority of patients pin responded to simple NSAIDS and Arm exercises. Keywords: Breast cancer, mastectomy, pain

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Increased risk of cardiovascular death in breast cancer patients without chemotherapy or (and) radiotherapy: a large population-based study.

10.21203/rs.3.rs-66895/v1 ◽

2020 ◽

Author(s):

Tianwang Guan ◽

Hanbin Zhang ◽

Jinming Yang ◽

Wenrui Lin ◽

Kenie Wang ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Tumor Resection ◽

Cardiovascular Death ◽

Female Breast Cancer ◽

Breast Cancer Patients ◽

Cvd Risk ◽

Female Breast ◽

Increased Risk ◽

The Impact

Abstract Background Cardiovascular death (CVD) in breast cancer patients without chemotherapy or (and) radiotherapy has not been studied yet. This study evaluates the correlation between breast cancer and CVD risk independent of chemotherapy (CT) or (and) radiotherapy (RT). Methods Data of female breast cancer patients without receiving CT or RT were retrieved from the Surveillance, Epidemiology, and End Result (SEER) database (2004–2015). Data were divided into two cohorts: Patients who underwent tumor resection (resection cohort) and those who didn’t undergo resection (no resection cohort). The CVD risk in patients was expressed as standardized mortality ratios (SMRs). A 1:1 propensity score matching (PSM) was applied to balance inter-group bias, and competing risk regressions were utilized to evaluate the impact of tumor resection on CVD. Results The CVD risk was significantly higher (SMR = 2.196, 95% CI:2.148–2.245, P < 0.001) in breast cancer patients who did not receive CT or RT compared to the general population. Breast cancer patients who did not undergo tumor resection showed a higher CVD risk than patients who underwent tumour resection (tumor resection SMR = 2.031, 95% CI: 1.983–2.079, P < 0.001; no resection SMR = 5.425, 95% CI:5.087–5.781, P < 0.001). After PSM, the CVD risk among patients without tumor resection indicated an increase of 1.165-fold compared to the patients with tumor resection (HR = 1.165, 95% CI: 1.039–1.306, P = 0.009). Conclusions Female breast cancer patients are at higher risk of CVD despite unexposure to cardio-toxic CT or RT. However, female breast cancer patients subjected to tumor resection have decreased CVD risk. This study suggests that monitoring female breast cancer patients not receiving RT or CT might serve as a preventative measure against CVD.

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BRCA1/2 Mutations and Long-Term Clinical Outcomes in Egyptian Breast Cancer Patients

Tumori Journal ◽

10.1177/03008916211012333 ◽

2021 ◽

Vol 107 (1_suppl) ◽

pp. 4-4

Author(s):

SG AbdelHamid ◽

HO El-Mesallamy ◽

HM AbdelAziz ◽

ARN Zekri

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Female Breast Cancer ◽

Breast Cancer Patients ◽

Term Survival ◽

Free Survival ◽

Female Breast ◽

Brca Carriers

Introduction: Clinical findings regarding the impact of BRCA1/2 mutational status on the prognosis of breast cancer patients are still controversial. We aimed to investigate the prognostic relevance of BRCA1/ 2 mutations on recurrence and long-term survival, for the first time, in Egyptian female breast cancer patients. Patients and Methods: The study cohort comprised 103 Egyptian female breast cancer patients previously tested for BRCA1/2 mutations using HRM analysis and direct sequencing. Clinicopathological and long-term clinical follow-up data including date and site of disease progression, were retrieved from medical records until death or loss to follow-up. Outcome measures including overall survival (OS), disease-free survival (DFS), recurrence-free survival, and metastasis-free survival (MFS) were compared in all BRCA1/ 2 mutation carriers versus non-carriers at 2, 5, 10, and 15 years after diagnosis. Results: The profile of the detected variants was previously reported. The American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG/AMP) guidelines were used to re-classify the variants. The median follow-up time was 6.9 years (range, 4.2-24.4 years). BRCA carriers had significantly worse DFS than non-carriers, at 2 years 86.7% vs 88.2%; at 5 years 38.1% vs 57.8%; and at 10 years 21.6% vs 34.1% ( P=0.024). Negative estrogen receptor (ER) status (HR=2.44, 95%CI=1.33-4.47) and large tumor size (HR=2.19, HR=1.21-3.98) were also significant factors for worse DFS. Recurrence-free survival was significantly worse in BRCA carriers compared to non-carriers, at 5 years: 95.2% vs 98.2%; at 10 years: 54.4% vs 79.8%; and at 15 years 34.6% vs 61.7% ( P=0.005). BRCA carriers showed poorer OS and MFS, though not statistically significant [OS in BRCA carriers and non-carriers at 5 years: 81.6% vs 89.3%; at 10 years: 59.2% vs 60.6%; and at 15 years: 36.3 vs 59.2% ( P=0.42); and MFS at 2 years 86.7% vs 88.1%; at 5 years 44.5% vs 61.1% ; and at 10 years: 25.3% vs 38.2% ( P=0.41)]. Conclusion: To our knowledge, this is the first study in the Middle East to investigate long-term survival outcome of BRCA1/2 related breast cancer. We, herein, underline the necessity of implementing BRCA screening strategies and intensive surveillance in the mainstream oncology practice in Egypt.

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