Top

World Journal of Surgery

Published in:

01-05-2018 | Original Scientific Report

Low Lifetime Risk of Contralateral Breast Cancer in a Middle-Income Asian Country: Evidence to Guide Post-treatment Surveillance

Authors: M. H. See, N. Bhoo-Pathy, S. Jamaris, A. Kiran, D. G. Evans, C. H. Yip, N. A. Taib

Published in: World Journal of Surgery | Issue 5/2018

Abstract

Background

The rate of contralateral risk-reducing mastectomy (CRRM) is increasing in the West with controversial evidence of improved survival in early breast cancer patients. Although uptake of CRRM in Asia appears low, the trends may rise, and there is currently an urgent need to provide evidence for informed decision-making in clinical practice. This study aims to determine the risk of contralateral breast cancer (CBC) and its associated factors in an Asian setting.

Method

A total of 2937 newly diagnosed patients with stage I and stage II breast cancer in University Malaya Medical Centre between Jan 1993 to Dec 2012 were included in the study. Multinomial logistic regression analysis allowing death to compete with CBC as a study outcome was used; patients with unilateral breast cancer who were alive were taken as reference. A stepwise backward regression analysis including age at diagnosis, ethnicity, family history of breast cancer, TNM stage, hormonal receptor status, HER2 status, chemotherapy, radiotherapy, and hormone therapy was conducted.

Results

Fifty women developed CBC, over a median follow-up of 6 years. The 5- and 10-year cumulative risk of contralateral breast cancer was 1.0% (95% CI 0.6–1.4%) and 2.8% (95% CI 2.0–3.6%), respectively. Young age at diagnosis of first cancer, positive family history, and stage I disease were independent predictors of CBC.

Discussion

The current study suggests that the risk of CBC is very low in a Southeast Asian setting. Any recommendations or practice of CRRM should be reviewed with caution and patients must be counseled appropriately.

Allemani C, Weir HK, Carreira H et al (2015) Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet 385(9972):977–1010CrossRefPubMed

Saadatmand S, Bretveld R, Siesling S et al (2015) Influence of tumour stage at breast cancer detection on survival in modern times: population based study in 173,797 patients. BMJ 351:h4901CrossRefPubMedPubMedCentral

Early Breast Cancer Trialists’ Collaborative Group (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and15-year survival: an overview of the randomized trials. Lancet 365(9472):1687–1717CrossRef

Clarke M, Collins R, Darby S et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366(9503):2087–2106CrossRefPubMed

Bodai BI, Tuso P (2015) Breast cancer survivorship: a comprehensive review of long-term medical issues and lifestyle recommendations. Perm J. 19(2):48–79. https://doi.org/10.7812/TPP/14-241 CrossRefPubMedPubMedCentral

Rasmussen CB, Kjær SK, Ejlertsen B et al (2014) Incidence of metachronous contralateral breast cancer in Denmark 1978–2009. Int J Epidemiol 43(6):1855–1864CrossRefPubMed

Chen Y, Thompson W, Semenciw R et al (1999) Epidemiology of contralateral breast cancer. Cancer Epidemiol Biomarkers Prev 8(10):855–861PubMed

Graeser MK, Engel C et al (2009) Contralateral breast cancer risk in BRCA1 and BRCA2 mutation carriers. J Clin Oncol 27(35):5887CrossRefPubMed

Fayanju OM, Stoll CR, Fowler S, Colditz GA, Margenthaler JA (2014) Contralateral prophylactic mastectomy after unilateral breast cancer: a systematic review and meta-analysis. Ann Surg 260(6):1000–1010CrossRefPubMedPubMedCentral

10.

Lostumbo L, Carbine NE, Wallace J (2010) Prophylactic mastectomy for the prevention of breast cancer. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD002748.pub3 PubMed

11.

Kurian AW, Lichtensztajn DY, Keegan TH et al (2014) Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998-2011. JAMA 312:902–914CrossRefPubMedPubMedCentral

12.

Tuttle TM, Habermann EB, Grund EH et al (2007) Increasing use of contralateral prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol 25(33):5203–5209CrossRefPubMed

13.

Sim Y, Tan VK, Ho GH et al (2014) Contralateral prophylactic mastectomy in an Asian population: a single institution review. Breast 23(1):56–62CrossRefPubMed

14.

Pathy NB, Yip CH, Taib NA et al (2011) Breast cancer in a multi-ethnic Asian setting: results from the Singapore–Malaysia hospital-based breast cancer registry. Breast 20(2):S75–S80CrossRefPubMed

15.

Gao X, Fisher SG, Emami B (2003) 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(4):1038–1045CrossRefPubMed

16.

Li CI, Malone KE, Weiss NS et al (2001) Tamoxifen therapy for primary breast cancer and risk of contralateral breast cancer. J Natl Cancer Inst 93:1008–1013CrossRefPubMed

17.

Schaapveld M, Visser O, Louwman WJ et al (2008) The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic signifi-cance of contralateral breast cancer: a population based study in the Netherlands. Breast Cancer Res Treat 110(1):189–197CrossRefPubMed

18.

Nichols HB, Berrington de Gonzalez A, Lacey JV et al (2011) Declining incidence of contralateral breast cancer in the United States from 1975 to 2006. J Clin Oncol 29(12):1564–1569CrossRefPubMedPubMedCentral

19.

Aihara T, Tanaka S, Sagara Y et al (2014) Incidence of contralateral breast cancer in Japanese patients with unilateral minimum-risk primary breast cancer, and the benefits of endocrine therapy and radiotherapy. Breast Cancer 21(3):284–291CrossRefPubMed

20.

Healey EA, Cook EF, Orav EJ et al (1993) Contralateral breast cancer: clinical characteristics and impact on prognosis. J Clin Oncol 11(8):1545–1552CrossRefPubMed

21.

Kollias J, Ellis IO, Elston CW et al (1999) Clinical and histological predictors of contralateral breast cancer. Eur J Surg Oncol 25(6):584–589CrossRefPubMed

22.

Robbins GF, Berg JW (1964) Bilateral primary breast cancer: a prospective clinicopathological study. Cancer 17:1501–1527CrossRefPubMed

23.

Marmor S, Portschy PR, Burke EE et al (2017) Prognostic factors for metachronous contralateral breast cancer: implications for management of the contralateral breast. Breast J 23(3):299–306CrossRefPubMed

24.

Prater J, Valeri F, Korol D et al (2016) Incidence of metachronous contralateral breast cancer in the Canton of Zurich: a population-based study of the cancer registry. J Cancer Res Clin Oncol 142(2):365–371CrossRefPubMed

25.

Yadav BS, Sharma SC, Patel FD et al (2008) Second primary in the contralateral breast after treatment of breast cancer. Radiother Oncol 86(2):171–176CrossRefPubMed

26.

Lizarraga IM, Sugg SL, Weigel RJ et al (2013) Review of risk factors for the development of contralateral breast cancer. Am J Surg 206(5):704–708CrossRefPubMed

27.

Bernstein JL, Lapinski RH, Thakore SS et al (2003) The descriptive epidemiology of second primary breast cancer. Epidemiology 14:552–558CrossRefPubMed

28.

Chen Y, Thompson W, Semenciw R et al (1999) Epidemiology of Contralateral breast Cancer. Cancer Epidemiol Biomark Prev 8:855–861

29.

Narod SA, Kharazmi E, Fallah M et al (2016) The risk of contralateral breast cancer in daughters of women with and without breast cancer. Clin Genet 89(3):332–335CrossRefPubMed

30.

King TA, Sakr R, Patil S et al (2011) Clinical management factors contribute to the decision for contralateral prophylactic mastectomy. J Clin Oncol 29(16):2158–2164CrossRefPubMed

31.

Boughey JC, Hoskin TL, Degnim AC et al (2010) Contralateral prophylactic mastectomy is associated with a survival advantage in high-risk women with a personal history of breast cancer. Ann Surg Oncol 17(10):2702–2709CrossRefPubMedPubMedCentral

32.

Portschy PR, Kuntz KM, Tuttle TM (2014) Survival outcomes after contralateral prophylactic mastectomy: a decision analysis. J Natl Cancer Inst 106(8):16CrossRef

33.

Boughey JC, Schilz SR, Van Houten HK, Zhu L et al (2017) Contralateral Prophylactic Mastectomy with Immediate Breast Reconstruction Increases Healthcare Utilization and Cost. Ann Surg Oncol. https://doi.org/10.1245/s10434-017-5983-3

34.

Boughey JC, Attai DJ, Chen SL et al (2016) Contralateral Prophylactic Mastectomy (CPM) Consensus Statement from the American Society of Breast Surgeons: data on CPM Outcomes and Risks. Ann Surg Oncol 23(10):3100–3105CrossRefPubMedPubMedCentral

35.

Molina-Montes E, Pérez-Nevot B, Pollán M, Sánchez-Cantalejo E et al (2014) Cumulative risk of second primary contralateral breast cancer in BRCA1/BRCA2 mutation carriers with a first breast cancer: a systematic review and meta-analysis. Breast 23(6):721–742CrossRefPubMed

36.

Tesson S, Richards I, Porter D et al (2017) Women’s preferences for contralateral prophylactic mastectomy following unilateral breast cancer: What risk-reduction makes it worthwhile? Breast 31:233–240CrossRefPubMed

Title: Low Lifetime Risk of Contralateral Breast Cancer in a Middle-Income Asian Country: Evidence to Guide Post-treatment Surveillance
Authors: M. H. See
N. Bhoo-Pathy
S. Jamaris
A. Kiran
D. G. Evans
C. H. Yip
N. A. Taib
Publication date: 01-05-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 5/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4319-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Low Lifetime Risk of Contralateral Breast Cancer in a Middle-Income Asian Country: Evidence to Guide Post-treatment Surveillance

Abstract

Background

Method

Results

Discussion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Discussion

Please log in to get access to this content

Other articles of this Issue 5/2018

Short- and Long-Term (10-year) Results of an Organized, Population-Based Breast Cancer Screening Program: Comparative, Observational Study from Hungary

Esophagectomy for End-Stage Achalasia: Systematic Review and Meta-analysis

Mesh Versus Patch Repair for Epigastric and Umbilical Hernia (MORPHEUS Trial); One-Year Results of a Randomized Controlled Trial

Clinical Outcomes of Gastric Cancer Patients Who Underwent Proximal or Total Gastrectomy: A Propensity Score-Matched Analysis

A Prospective Comparative Study on Improvement of Hyperthyroid Cardiovascular Dysfunction in Patients Undergoing Total Thyroidectomy Versus Medical Management

Preoperative Imaging Overestimates the Tumor Size in Pancreatic Neuroendocrine Neoplasms Associated with Multiple Endocrine Neoplasia Type 1