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Risk of Second Cancer by Hormone Receptor Status Among Breast Cancer Survivors


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A new study has found breast cancer survivors in general have higher risk of new cancer diagnosis compared to healthy individuals. The article, published by Hyuna Sung, PhD, and colleagues in the journal Cancer, stated that compared to the general population in the United States, the risk of new cancer diagnoses among survivors was 20% higher for those with hormone receptor–positive cancers and 44% higher for those with hormone receptor–negative cancers.

Breast cancer is the most commonly diagnosed and prevalent cancer among women in the United States, with over 3.9 million living breast cancer survivors as of 2019. The number of survivors is expected to increase with the aging population and advances in breast cancer treatment. Subsequent primary cancer after breast cancer is a well-known late effect, but the risk by breast cancer subtype and age at diagnosis was largely unknown, except for contralateral breast, lung, and ovarian cancers. This study is the first to examine the risk of a range of subsequent primary cancers (including 26 types) and evaluate the risk by tumor subtypes and age at diagnosis of breast cancer.


With most women living decades after a breast cancer diagnosis, it is important to identify survivors at higher risk for future cancers and provide tailored recommendations for risk reduction and early detection.
— Hyuna Sung, PhD

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"With most women living decades after a breast cancer diagnosis, it is important to identify survivors at higher risk for future cancers and provide tailored recommendations for risk reduction and early detection," said Dr. Sung.

Study Details

This study included women aged 20 to 84 years diagnosed with invasive breast cancer from 1992 to 2015 and who survived for a year or more.

Data showed that the risk differs by survivor characteristics, such as breast cancer subtypes and their diagnosis age. For example, several cancers—including subsequent breast cancer, acute nonlymphocytic leukemia, ovarian cancer, and lung cancer—are more likely to develop after hormone receptor–negative cancer than after hormone receptor–positive cancer. Women who were first diagnosed with breast cancer before age 50 also had a greater risk for subsequent cancer than women with later-onset breast cancer. After breast cancer, the greatest excess absolute risks were for ovarian cancer among early‐onset hormone receptor–negative survivors, lung cancer among early‐ and late‐onset hormone receptor–negative survivors, and uterine corpus cancer among late‐onset hormone receptor–positive survivors.

"Differential risk of subsequent cancer according to survivor characteristics highlights that more targeted approaches for cancer prevention and early detection strategies are needed in survivorship care planning to mitigate the burden of subsequent cancers in the growing population of survivors," said the authors.

Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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