Breast cancer survivors are at a higher risk of getting another breast cancer, as well as some other types of cancer. The most common second cancer is another breast cancer either at the same side or on the opposite side. Various factors are implicated in increasing the risk of second primary like hormonal therapy, radiation to the breast and axilla and chemotherapy. We aimed to asses the risk of second cancers in breast cancer survivors.
A retrospective audit was done at amrita institute of medical sciences by including patients with breast cancer treated between 2005 and 2015.
A total of 3470 breast cancers were included, 37.9%, 48.1% and 14% were EBC, LABC and MBC at presentation. 49 patients presented with second primary with a incidence of 1.4%. Median age was 51.4 years. The most common second primary was breast cancer 16 (Ipsilateral - 5, contralateral - 11), Ovarian cancer in 6 patients, Gastrointestinal malignancies in 12, endometrial carcinoma in 3, acute myeloid leukemia in 3 and thyroid carcinoma in 3 patients. The survival outcomes in patients with second malignancies were poor with 3 years overall survival of 38%. Majority (74%) of the patients received adjuvant chemotherapy with AC followed by Taxol including radiation (72%) as part of their primary treatment. Median time interval for development of second primary was 543 days.
Second primary in patients with breast cancer is not a rarity, these patients need to be on long term follow for early diagnosis and treatment. Genetic testing should be considered in patients with history of familial cancers, as genetic testing is not routinely practised due to logistic issues in our patient population, there is immediate need for diagnostics at a low cost to make it affordable to our patients.
Amrita Institute of Medical Sciences.
Has not received any funding.
All authors have declared no conflicts of interest.