Second Breast Cancer
We all agree that it is wonderful that more women who have been treated for breast cancer survive and live long and healthy lives. It has, however, become clear that there may be medium and long term effects of cancer treatments, and that we are living long enough to develop other problems. This editorial from JNCI by David Brenner, PhD, ScD from Columbia University Medical Center discusses the possibility of later developing a second primary breast cancer. A second cancer can be either in the same breast (where it is more common to have a local recurrence of the first, but also possible to develop an unrelated one) or the other/contralateral breast. Since my personal history includes two primary breast cancers, one in 1993 and one in 2005, I fit this description. Here is a quote and thena link to read more:
Long-term survival after a breast cancer diagnosis has increased markedly in the last decade: 15-year relative survival in the United States is now 75% (1), up from 58% in 2001. This increase is due in part to earlier detection but also to improved treatment options (2,3). So it is highly appropriate that increasing attention is being paid to the issue of breast cancer survivorship and, in particular, the issue of second breast cancers. Several long-term studies suggest that contralateral second breast cancer rates range from 10% to 15% at 15 years after treatment and are even higher for still longerterm survivors (4,5).
The risk of a breast cancer survivor developing a second breast cancer is much higher than the risk of a comparable healthy woman developing a first breast cancer. For example, a healthy 55-year-old woman has about a 2.5% chance of developing invasive cancer in a given breast over the next 15 years, whereas a 55-year-old breast cancer survivor has a 10%-15% chance of developing invasive cancer in the contralateral breast over the next 15 years. Only a small component of this disturbingly large risk of a second breast cancer is treatment related: If anything, some chemotherapy regimens may reduce the rate of second breast cancers (6), and the comparatively low and inhomogeneous dose of scattered or leakage radiation to the contralateral breast during radiotherapy (7) results in only a small increase in the risk of contralateral breast cancer (5,8-)