Muneer J Al-Husseini1, Hadeer H Mohamed1, Anas M Saad1, Mohamed M Gad2, Mona Atia3, Umniyah Qaddoora1, Abdelrahman Ibrahim Abushouk4, Mohamed El-Shinawi5. 1. Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2. Faculty of Medicine, Ain Shams University, Cairo, Egypt; Cleveland Clinic Foundation, Cleveland, Ohio. 3. Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 4. Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: Abdelrahman.abushouk@med.asu.edu.eg. 5. General Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Abstract
BACKGROUND: We aimed to investigate the risk and survival of chronic myeloid leukemia (CML) after breast cancer (BC) diagnosis. METHODS: We used the Surveillance, Epidemiology, and End Results 'SEER' database. Females, diagnosed with BC between 1992 and 2014, were selected and followed for the development of CML after a 6-month latency period from BC diagnosis. We used the Multiple Primary Standardized Incidence Ratios session of the SEER*Stat software (version 8.3.4) to calculate the Observed/Expected (O/E) ratios with 95% confidence intervals (CI). To calculate the overall survival, we performed an unadjusted Kaplan-Meier analysis using the SPSS software. RESULTS: We included 474,866 females with BC, of which 178 were later diagnosed with CML. We found the risk of CML to increase significantly after BC diagnosis (O/E = 1.26, 95% CI: 1.08-1.45) and the risk was specifically higher within the first 5 years of diagnosis (O/E = 1.45, 95% CI: 1.16-1.8). When the risk was stratified by cancer stage, localized BC was associated with a significant increase in CML risk within 5 years of diagnosis (O/E = 1.4, 95% CI: 1.06-1.82), while regional BC was associated with a significant increase in CML risk after more than 5 years of diagnosis (O/E = 1.59, 95% CI: 1.09-2.25). Moreover, radiotherapy, chemotherapy, and presence of hormonal receptors were associated with a significant increase in CML risk in BC patients. The median overall survival of CML after BC was 28 months. CONCLUSION: Breast cancer patients have an increased risk of developing CML and further investigation is required to establish the causes of this finding.
BACKGROUND: We aimed to investigate the risk and survival of chronic myeloid leukemia (CML) after breast cancer (BC) diagnosis. METHODS: We used the Surveillance, Epidemiology, and End Results 'SEER' database. Females, diagnosed with BC between 1992 and 2014, were selected and followed for the development of CML after a 6-month latency period from BC diagnosis. We used the Multiple Primary Standardized Incidence Ratios session of the SEER*Stat software (version 8.3.4) to calculate the Observed/Expected (O/E) ratios with 95% confidence intervals (CI). To calculate the overall survival, we performed an unadjusted Kaplan-Meier analysis using the SPSS software. RESULTS: We included 474,866 females with BC, of which 178 were later diagnosed with CML. We found the risk of CML to increase significantly after BC diagnosis (O/E = 1.26, 95% CI: 1.08-1.45) and the risk was specifically higher within the first 5 years of diagnosis (O/E = 1.45, 95% CI: 1.16-1.8). When the risk was stratified by cancer stage, localized BC was associated with a significant increase in CML risk within 5 years of diagnosis (O/E = 1.4, 95% CI: 1.06-1.82), while regional BC was associated with a significant increase in CML risk after more than 5 years of diagnosis (O/E = 1.59, 95% CI: 1.09-2.25). Moreover, radiotherapy, chemotherapy, and presence of hormonal receptors were associated with a significant increase in CML risk in BC patients. The median overall survival of CML after BC was 28 months. CONCLUSION:Breast cancerpatients have an increased risk of developing CML and further investigation is required to establish the causes of this finding.
Authors: Rosalia Ragusa; Antonina Torrisi; Alessia Anna Di Prima; Antonietta A Torrisi; Antonella Ippolito; Margherita Ferrante; Anselmo Madeddu; Vincenzo Guardabasso Journal: Int J Environ Res Public Health Date: 2022-09-26 Impact factor: 4.614