Risk of contralateral second primary breast cancer according to hormone receptor status in Germany

Introduction: Hormone receptor (HR) status has become an established target in treatment strategies of breast cancer. Population-based estimates of contralateral breast cancer (CBC) incidence by HR subtype in particular are limited. The aim of this study was to provide detailed data on CBC incidence for Germany. Methods: Invasive breast cancer data were extracted on 49,804 women yielding 594 second primaries from the cancer registries of the Federal States of Brandenburg and Saarland and the area of Munich for the period from 1998 to 2007. Multiple imputation was used on missing values for HR status. We estimated standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs). Results: SIR estimates of CBC among women diagnosed with an invasive first primary breast cancer (FBC) of any HR subtype ranged from 1.0 to 1.5 in the three registries. Pooling three registries' data, the SIR of HR-positive CBC was 0.7 (95% CI: 0.6 to 0.8) among women with HR-positive FBC. For those women with HR-negative FBC, the SIR of HR-negative CBC was 8.9 (95% CI: 7.1 to 11.1). Among women with FBC diagnosed before the age of 50 years, incidence of CBC was increased, especially for HR-negative FBC (SIR: 9.2; 95% CI: 7.1 to 11.9). Conclusions: HR status of the first primary and age at first diagnosis is relevant for predicting risk of CBC. Particularly, patients with HR-negative FBC had elevated risks

Risk of contralateral second primary breast cancer according to hormone receptor status in Germany

Introduction: Hormone receptor (HR) status has become an established target in treatment strategies of breast cancer. Population-based estimates of contralateral breast cancer (CBC) incidence by HR subtype in particular are limited. The aim of this study was to provide detailed data on CBC incidence for Germany. Methods: Invasive breast cancer data were extracted on 49,804 women yielding 594 second primaries from the cancer registries of the Federal States of Brandenburg and Saarland and the area of Munich for the period from 1998 to 2007. Multiple imputation was used on missing values for HR status. We estimated standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs). Results: SIR estimates of CBC among women diagnosed with an invasive first primary breast cancer (FBC) of any HR subtype ranged from 1.0 to 1.5 in the three registries. Pooling three registries' data, the SIR of HR-positive CBC was 0.7 (95% CI: 0.6 to 0.8) among women with HR-positive FBC. For those women with HR-negative FBC, the SIR of HR-negative CBC was 8.9 (95% CI: 7.1 to 11.1). Among women with FBC diagnosed before the age of 50 years, incidence of CBC was increased, especially for HR-negative FBC (SIR: 9.2; 95% CI: 7.1 to 11.9). Conclusions: HR status of the first primary and age at first diagnosis is relevant for predicting risk of CBC. Particularly, patients with HR-negative FBC had elevated risks

Evaluation of the secondary cancer risk based on the data of the clinical cancer registry of the country Brandenburg

Zielstellung der vorliegenden Arbeit war die Ermittlung des Zweiterkrankungsrisikos, der häufigsten Lokalisationen eines zweiten Tumors sowie der kumulativen Zweittumorrate aus den Daten des bundeslandweiten, flächendeckenden klinischen Krebsregisters in Brandenburg. Dafür standen Daten von insgesamt 106.730 Patienten (331.804 Personenjahre unter Risiko) zur Verfügung. Die Analysen erfolgten für Krebs insgesamt und Ersttumoren der folgenden sechs Organsysteme nach ICD-O-3: Lippe, Mundhöhle, Pharynx (C00 – C14), Verdauungsorgane (C15 – C26), Atemwege und intrathorakale Organe (C30 – C39), weibliche Geschlechtsorgane (C51 – C58), männliche Geschlechtsorgane (C60 – C63) und Harntrakt (C64 – C68). Eine detailliertere Datenanalyse erfolgte für die 15.125 Patientinnen mit einem Ersttumor der weiblichen Brust. Im Ergebnis der Arbeit wurde festgestellt, dass Tumorpatienten ein erhöhtes Zweiterkrankungsrisiko haben. Es ist für Frauen, unabhängig von der Entität des Ersttumors, 1,5fach und für Männer 1,3fach erhöht, verglichen mit der Krebsinzidenz in der Normalbevölkerung. Das höchste Zweiterkrankungsrisiko haben Männer und Frauen mit einem Tumor des Mund- und Rachenraumes (C00 – C14). An zweiter Stelle stehen Männer und Frauen nach einem Tumor des Harntraktes (C64 – C68) sowie Frauen nach einem Mammakarzinom.The objective of this PhD work was the estimation of the secondary disease risk for the most frequently localised kind of subsequent cancer as well as its cumulative rate. The estimation is based on the data of the countrywide working clinical cancer registry in Brandenburg. For this purpose in total 106.730 sets of data were available (331.804 person years at risk).The analysis was performed for all kind of cancer and for primary cancer of seven different cancer sites (lip, oral cavity and pharynx (C00-C14), digestive tract (C15-26), respiratory tract (C30-39), female genital tract (C51-C58), male genital tract (C60-C63), urinary tract (C64-C68). A detailed analysis of the data was done for 15.125 female patients with primary breast cancer. As a general result of the work it was determined that patients who have a primary cancer already have an increased secondary disease risk. For females the risk is 1.5 times and for males 1.3 times higher compared to the cancer incidence of the normal population regardless on the site of the primary cancer. The highest secondary cancer risk was found for males and females after initial cancer of the lip, oral cavity and pharynx. (C00-C14) followed by males and females after cancer of the urinary tract (C64-C68) and by females after breast cancer