Gesundheitswesen 2017; 79(08/09): 656-804
DOI: 10.1055/s-0037-1605774
Vorträge
Georg Thieme Verlag KG Stuttgart · New York

Secondary malignant neoplasms among breast cancer patients in Germany: 1990 – 2013

L Liang
1   Technische Universität München, Epidemiologie, Fakultät für Sport- und Gesundheitswissenschaften, München
,
O Schoffer
1   Technische Universität München, Epidemiologie, Fakultät für Sport- und Gesundheitswissenschaften, München
,
D Schweigler
2   Technische Universität Dresden, Cancer Epidemiology, University Cancer Center, University Hospital, Dresden
,
K Kraywinkel
3   Robert Koch-Institut, Zentrum für Krebsregisterdaten, Berlin
,
SJ Klug
1   Technische Universität München, Epidemiologie, Fakultät für Sport- und Gesundheitswissenschaften, München
› Author Affiliations
Further Information

Publication History

Publication Date:
01 September 2017 (online)

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Background:

A Second Malignant Neoplasm (SMN) is a second cancer that develops after a primary cancer has occurred. Increases in SMN are expected due to increased survival times made possible by advances in cancer therapy, and suspected from therapy of primary cancers. SMN studies among breast cancer patients in Germany are few. We aim to look at the incidence of metachronous SMN in female breast cancer patients between the years 1990 and 2013. Factors that potentially influence SMN such as therapy, tumour stage and demographics will be investigated.

Methods:

Data stem from the German Centre for Cancer Registry Data (ZfKD), containing population-based information on histology, therapy and basic anonymised patient demographics. We included females over 18 years old with a primary breast cancer diagnosis between the years 1990 and 2013, and excluded males and non-metachronous breast cancers. All cases were coded according to the International Classification of Diseases for Oncology (ICD-0) and the International Classification of Diseases (ICD-10). Time trend analyses and cox proportional hazards regressions were applied.

Results:

Between 1990 and 2013, 287 353 breast cancer cases were reported. Of these, 14 799 (5.2%) were diagnosed with a metachronous SMN. SMN were frequently reported in the bowel (ICD-10 C18-C21; 19.2%), uterus (C54, C55; 11.2%), lung (C33, C34; 10.9%), ovary (C56; 6.6%) and stomach (C16; 5.7%). Mean SMN diagnosis age was 63.1 years (Confidence Interval CI95% 62.9 – 63.3) with slight annual increases over time. Mean latency time from primary cancer to SMN was 6.7 years (CI95% 6.6 – 6.8). Preliminary modelling suggest associations between SMN and age, region, histology, tumour stage and therapy.

Conclusion:

In Germany approximately 5.2% of breast cancer survivors were diagnosed with SMN, which may be influenced by several factors. More research is needed to see whether a SMN is influenced by primary cancer treatment as well as lifestyle factors.