Characteristics of second primary breast cancer after ovarian cancer: a Korea central cancer registry retrospective study

Eun-Gyeong Lee; Jiwon Lim; Hyeong In Ha; Myong Cheol Lim; Yoon Jung Chang; Young-Joo Won; So-Youn Jung

doi:10.3389/fonc.2023.1208320

Characteristics of second primary breast cancer after ovarian cancer: a Korea central cancer registry retrospective study

Front Oncol. 2023 Sep 14:13:1208320. doi: 10.3389/fonc.2023.1208320. eCollection 2023.

Authors

Eun-Gyeong Lee¹, Jiwon Lim², Hyeong In Ha³, Myong Cheol Lim^{4

5

6}, Yoon Jung Chang^{5

7}, Young-Joo Won⁸, So-Youn Jung^{1

9}

Affiliations

¹ Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
² Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
³ Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
⁴ Center for Gynecologic Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
⁵ Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea.
⁶ Division of Tumor Immunology, Research Institute, National Cancer Center, Goyang, Republic of Korea.
⁷ Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
⁸ Division of Health Administration, Yonsei University, Wonju, Republic of Korea.
⁹ Cancer Healthcare Research Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea.

Abstract

Background: Second primary cancer has become an important issue among cancer survivors. This study sought to determine the differences in clinicopathologic outcomes between second primary breast cancer (SPBC) after ovarian cancer and primary breast cancer (PBC) in the Republic of Korea.

Methods and materials: We searched the Korea Central Cancer Registry and identified 251,244 breast cancer cases that were diagnosed between 1999 and 2017. The incident rate and standardized incidence ratio (SIR) were calculated. Demographic and clinical characteristics and overall survival (OS) rates were estimated according to age, histological type, and cancer stage.

Results: Among the 228,329 patients included, 228,148 were patients with PBC, and 181 patients had SPBC diagnosed after ovarian cancer (OC). The mean ages at diagnosis were 56.09 ± 10.81 years for SPBC and 50.65 ± 11.40 years for PBC. Patients with SPBC were significantly less likely than patients with PBC to receive adjuvant radiotherapy (14.92% vs. 21.92%, p = 0.02) or adjuvant chemotherapy (44.75% vs. 55.69%, p < 0.01). Based on the age-standardized rate (ASR), the incidence of SPBC after OC was 293.58 per 100,000 ovarian cancer patients and the incidence of PBC was 39.13 per 100,000 women. The SIR for SPBC was 1.27 (1.09-1.46, 95% Confidence interval) in the patients overall. The 5-year OS rates were 72.88% and 89.37% for SPBC and PBC (p < 0.01). The OS rate in SPBC decreased significantly with advanced stage and older age.

Conclusion: The incidence of breast cancer is about 1.27 times higher in ovarian cancer patients than in healthy people. The survival outcomes were worse for SPBC than for PBC and were related to older age and advanced stage. Active screening for breast cancer is necessary in ovarian cancer patients.

Keywords: breast cancer; incidence; ovarian cancer; second primary; survival.

Grants and funding

This study was supported by National Cancer Center Grants (NCC-1910132, NCC-1911272, NCC-1911274, NCC-2243330-1) and “Regional Innovation Strategy (RIS)” through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (MOE) (2022RIS-005). The funders had no role in the design of this study, curation, analysis, and interpretation of data, the writing of the manuscript, and the decision to publish this study.