Abstract
First primary, or unilateral, breast cancer (UBC) cases diagnosed in 1960–89 at the Cancer Institute (WIA), Chennai, India were followed‐up until December 31, 1994. Patients with UBC (n=3163) and those who developed second cancer in the contralateral breast (CBC) after the initial breast cancer (n=67 or 2.1% of UBC) were analysed.
Compared to UBC patients, those who developed CBC were younger at the time of diagnosis of initial breast cancer and had higher frequency of breast cancer among the family members. The relative survival rate takes into account competing causes of death and was estimated as the ratio of observed survival rate to the expected survival rate. The cumulative relative survival from UBC at 5 and 10 years were 51% and 41%, respectively, and the corresponding rates for CBC were 47 and 30% the survival difference seen between UBC and CBC patients was not statistically significant. The survival rates among younger, middle-aged and older women were significantly different from each other in UBC but not in CBC patients. Both UBC and CBC with early stage disease had a better survival compared to late stage disease. Survival advantage was also seen among both UBC and CBC patients with family history of breast cancer compared to those without. The multivariate analysis by the life table proportional hazards model showed that the age at diagnosis is an independent prognostic factor for breast cancer. The study results should be interpreted in the light of small sample size of second cancers.
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References
Biennial report of the National Cancer Registry Programme: A project of the Indian Council of Medical Research, New Delhi, India, 1992
Sankaranarayanan R, Swaminathan R, Black RJ, on behalf of the study group on cancer survival in Developing countries: Global variations in cancer survival. Cancer 78: 2461–2464, 1996
Nandakumar A, Anantha N, Venugopal TC, Sankaranarayanan R, Thimmasetty K, Dhar M: Survival in breast cancer: a population-based study in Bangalore, India. Int J Cancer 60: 593–596, 1995
Gajalakshmi CK, Shanta V, Swaminathan R, Sankaranarayanan R, Black RJ: A population based survival study on female breast cancer in Madras, India. Br J Cancer 75: 771–775, 1997
Gajalakshmi CK, Shanta V, Hakama M: Risk factors for contralateral breast cancer in Chennai (Madras), India, Int J Epidemiol 27: 743–750, 1998
Gajalakshmi CK, Shanta V: Methodology for long term follow-up of cancer cases in a developing environment, Ind J Cancer 32: 160–168, 1995
Hermanek P, Sobin LH (eds): TNM Classification of Malignant Tumours. International Union Against Cancer, New York, 1987
Manual of the International Classification of Diseases for Oncology. 1st edition. World Health Organisation, Geneva, 1976
Registrar General of India: SRS Based Abridged Life Tables 1976–1980. Sample Registration Bulletin. Vol 18, No 1. Oflice of the Registrar General, New Delhi, 1984
Registrar General of India: SRS Based Abridged Life Tables 1985–1989. Occasional paper No 4 of 1990. Office of the Registrar General, New Delhi, 1990
Hakulinen T, Abeywickrama KH: A computer program package for relative survival analysis. Computer Prog Biomed 19: 197–207, 1985
Hakulinen T, Tenkanen L: Regression analysis of relative survival rates. Appl Stat 36: 309–317, 1987
Francis B, Green M, Payne C (eds): The GLIM system. Release 4 Manual. Generalised Linear Interactive Modelling, Oxford, 1993
Kurtz JM, Amalric R, Brandone H, Ayme Y, Spitalier JM: Contralateral breast cancer and other second malignancies in patients treated by breast-conserving therapy with radiation. Int J Radiat Oncol Biol Phys 15(2): 277–284, 1988
Brenner H, Engelsmann B, Stegmaier C, Ziegler H: Clinical epidemiology of bilateral breast cancer. Cancer 72: 3629–3635, 1993
Berrino F, Sant M, Verdecchia A, Capocaccia R, Hakulinen T, Esteve J (eds): The Eurocare Study - Survival of cancer patients in Europe. IARC Scientific Publication No 132. International Agency for Research on Cancer, Lyon, France, 1995
Yancik R, Ries LG, Yates JW: Breast cancer in aging women. A population-based study of contrasts in stage, surgery and survival. Cancer 63: 976–981, 1989
Finney GG Jr, Finney GG, Montague ACW, Stonesifer GL, Brown CC: Bilateral breast cancer: clinical and pathological review. Ann Surg 175: 635–646, 1972
Slack N, Bross KDJ, Nemoto T, Fisher B: Experiences with bilateral primary carcinoma of the breast. Surg Gynecol Obstet 136: 433–440, 1973
Khafagy MM, Schottenfeld D, Robbins GF: Prognosis of the second breast cancer: the role of previous exposure to the first primary. Cancer 35: 596–599, 1975
Schell SR, Montague ED, Spanos WJ Jr, Tapley ND, Fletcher GH, Oswald MJ: Bilateral breast cancer in patients with initial stage I and II disease. Cancer 50(6): 1191–1194, 1982
Burns PE, Dabbs K, May C, Lees AW, Birkett LR, Jenkins HJ, Hanson J: Bilateral breast cancer in northern Alberta risk factors and survival patterns. Can Med Assoc J 130: 881–886, 1984
Fisher ER, Fischer B, Sass R, Wickerham L and Collaborating NSABP investigators: Pathologic findings from the National Surgical Adjuvant Breast Project (Protocol No 4): XI Bilateral breast cancer. Cancer 54: 3002–3011, 1984
Berte E, Buzdar AU, Smith TL, Hortobagyi GN: Bilateral primary breast cancer in patients treated with adjuvant therapy. Am J Clin Oncol 11(2): 114–118, 1988
Holmberg L, Adami H-O, Ekbom A, Bergstrom R, Sandstrom A, Lindgren A: Prognosis in bilateral breast cancer. Effects of time interval between first and second primary tumours. Br J Cancer 58: 191–194, 1988
Gulay H, Hameloglu E, Bulut O, Goksel HA: Bilateral breast carcinoma: 28 years experience. World J Surg 14(4): 529–533, 1990
de-la-Rochefordiere A, Mouret-Fourme E, Asselain B, Scholl SM, Campana F, Broet P, Fourquet A: Metachronous contralateral breast cancer as first event of relapse. Int J Radiat Oncol Biol Phys 36: 615–621, 1996
Fisher ER: Prognostic and therapeutic significance of pathological features of breast cancer. Monogr Natl Cancer Inst 1: 29–34, 1986
Carter CL, Allen C, Henson DE: Relation of tumour size, lymphnode status and survival in 24,740 breast cancer cases. Cancer 63: 181–187, 1989
Crowe JP Jr, Gordon NH, Shenk RR, Zollinger RM Jr, Brumberg DJ, Shuck JM: Primary tumour size. Relevance to breast cancer survival. Arch Surg 127: 910–915, 1992
Lipponen P, Aaltomaa S, Eskelinen M, Kosma VM, Marin S, Syrjänen K: The changing importance of prognostic factors in breast cancer during long-term follow-up. Int J Cancer 51: 698–702, 1992
Nab HW, Kluck HM, Rutgers EJ, Coebergh JW, Hop WC: Long term prognosis of breast for a protective effect of lactation on risk of breast cancer in young women: results from a case-control study. Am J Epidemiol 124: 353–358, 1995
Engin K: Prognostic factors in bilateral breast cancer. Neoplasma 41: 353–357, 1994
Nemoto T, Vana J, Bedwani RN, Baker HW, McGregor FH, Murphy GP: Management and survival of female breast cancer: results of national survey by the American College of Surgeons. Cancer 45: 2917–2924, 1980
Aaltomaa S, Lipponen P, Eskelinen M: Demographic prognostic factors in breast cancer. Acta Oncol 31: 635–640, 1992
Albain KS, Allred DC, Clark GM: Breast cancer outcome and predictors of outcome: are there age differentials? Monogr Natl Cancer Inst 16: 35–42, 1994
Adami H-O, Malker B, Holmberg L, Persson I, Stone B: The relation between survival and age at diagnosis in breast cancer. N Engl J Med 315: 559–563, 1986
Host H, Lund E: Age as a prognostic factor in breast cancer. Cancer 57: 2217–2221, 1986
Alexieva-Figusch J, van Putten WLJ, Blankenstein MA, Blonk-Van Der Wijst J, Klijn JG: The prognostic value and relationships of patient characteristics, estrogen and progestin receptors, and site of relapse in primary breast cancer. Cancer 61: 758–768, 1988
Albain KS, Green S, LeBlanc M, Rivkin S, O'sullivan J, Osborne CK: Proportional hazards and recursive partitioning and amalgamation analyses of the Southwest Oncology Group node-positive adjuvant CMFVP breast cancer data base: a pilot study. Breast Cancer Res Treat 22: 273–284, 1992
Belembaogo E, Feillel V, Chollet P, Cure H, Verrelle P, Kwiatkowski F, Achard JL, Le Bouedec G, Chassagne J, Bignon YJ, de Latour M, Lafaye C, Dauplat J: Neoadjuvant chemotherapy in 126 operable breast cancers. Eur J Cancer 28(A): 896–900, 1992
Clark GM: The biology of breast cancer in older women. J Gerontol 47: 19–23, 1992
Chaudary MA, Millis RR, Bulbrook RD, Hayward JL: Family history and bilateral primary breast cancer. Breast Cancer Res Treat 5(2): 201–205, 1985
Gogas J, Markopoulos C, Skandalakis P, Gogas H: Bilateral breast cancer. Am Surg 59(11): 733–735, 1993
Fukutomi T, Kobayashi Y, Nanasawa T, Yamamoto H, Tsuda H: A clinicopathological analysis of breast cancer in patients with a family history. Surg Today 23: 849–854, 1993
Anderson DE, Badzioch MD: Survival in familial breast cancer patients. Cancer 58: 360–365, 1986
Toikkanen SP, Kujari HP, Joensuu H: Factors predicting late mortality from breast cancer. Eur J Cancer 27: 586–591, 1991
Swanson GM, Lin C-S: Survival patterns among younger women with breast cancer: effects of age, race, stage and treatment, Natl Cancer Inst Monogr 16: 69–77, 1994
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Gajalakshmi, C., Shanta, V. & Hakama, M. Survival from contralateral breast cancer. Breast Cancer Res Treat 58, 115–122 (1999). https://doi.org/10.1023/A:1006361608241
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DOI: https://doi.org/10.1023/A:1006361608241