Sandi L Pruitt1,2, Hong Zhu3,4, Daniel F Heitjan3,5, Asal Rahimi4,6, Bhumika Maddineni3, Anna Tavakkoli3,4,7, Ethan A Halm3,4,7, David E Gerber3,4,7, Danyi Xiong3,5, Caitlin C Murphy3,4. 1. Department of Population & Data Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9066, USA. Sandi.Pruitt@utsouthwestern.edu. 2. Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA. Sandi.Pruitt@utsouthwestern.edu. 3. Department of Population & Data Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9066, USA. 4. Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA. 5. Department of Statistical Science, Southern Methodist University, Dallas, TX, USA. 6. Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA. 7. Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Abstract
PURPOSE: Many women diagnosed with breast cancer have survived previous cancer; yet little is known about the impact of previous cancer on overall and cancer-specific survival. METHODS: This population-based cohort study using SEER-Medicare data included women (age ≥ 66 years) diagnosed with breast cancer between 2005 and 2015. Separately by breast cancer stage, we estimated effect of previous cancer on overall survival using Cox regression and on cause-specific survival using competing risk regression; all survival analyses adjusted for covariates. RESULTS: Of 138,576 women diagnosed with breast cancer, 8% had a previous cancer of another organ site, most commonly colorectal or uterine cancer or melanoma. Many of these women (46.3%) were diagnosed within 5 years of breast cancer. For all breast cancer stages except IV wherein there was no difference, women with vs. without previous cancer had worse overall survival. This survival disadvantage was driven by deaths due to the previous cancer and other causes. In contrast, women with previous cancer generally had favorable breast-cancer-specific survival, although this varied by stage. Overall survival varied by previous cancer type, timing, and stage; previous lung cancer, cancer diagnosed within 1 year of incident breast cancer, and previous cancer at a distant stage were associated with the worst survival. In contrast, women with a previous melanoma had equivalent overall survival to women without previous cancer. CONCLUSION: We observed variable impact of previous cancer on overall and breast-cancer-specific survival depending on breast cancer stage at diagnosis and the type, timing, and stage of previous cancer.
PURPOSE: Many women diagnosed with breast cancer have survived previous cancer; yet little is known about the impact of previous cancer on overall and cancer-specific survival. METHODS: This population-based cohort study using SEER-Medicare data included women (age ≥ 66 years) diagnosed with breast cancer between 2005 and 2015. Separately by breast cancer stage, we estimated effect of previous cancer on overall survival using Cox regression and on cause-specific survival using competing risk regression; all survival analyses adjusted for covariates. RESULTS: Of 138,576 women diagnosed with breast cancer, 8% had a previous cancer of another organ site, most commonly colorectal or uterine cancer or melanoma. Many of these women (46.3%) were diagnosed within 5 years of breast cancer. For all breast cancer stages except IV wherein there was no difference, women with vs. without previous cancer had worse overall survival. This survival disadvantage was driven by deaths due to the previous cancer and other causes. In contrast, women with previous cancer generally had favorable breast-cancer-specific survival, although this varied by stage. Overall survival varied by previous cancer type, timing, and stage; previous lung cancer, cancer diagnosed within 1 year of incident breast cancer, and previous cancer at a distant stage were associated with the worst survival. In contrast, women with a previous melanoma had equivalent overall survival to women without previous cancer. CONCLUSION: We observed variable impact of previous cancer on overall and breast-cancer-specific survival depending on breast cancer stage at diagnosis and the type, timing, and stage of previous cancer.
Authors: Mollie W Howerton; M Chris Gibbons; Charles R Baffi; Tiffany L Gary; Gabriel Y Lai; Shari Bolen; Jon Tilburt; Teerath Peter Tanpitukpongse; Renee F Wilson; Neil R Powe; Eric B Bass; Jean G Ford Journal: Cancer Date: 2007-02-01 Impact factor: 6.860
Authors: Hude Quan; Vijaya Sundararajan; Patricia Halfon; Andrew Fong; Bernard Burnand; Jean-Christophe Luthi; L Duncan Saunders; Cynthia A Beck; Thomas E Feasby; William A Ghali Journal: Med Care Date: 2005-11 Impact factor: 2.983
Authors: Edward S Kim; Suanna S Bruinooge; Samantha Roberts; Gwynn Ison; Nancy U Lin; Lia Gore; Thomas S Uldrick; Stuart M Lichtman; Nancy Roach; Julia A Beaver; Rajeshwari Sridhara; Paul J Hesketh; Andrea M Denicoff; Elizabeth Garrett-Mayer; Eric Rubin; Pratik Multani; Tatiana M Prowell; Caroline Schenkel; Marina Kozak; Jeff Allen; Ellen Sigal; Richard L Schilsky Journal: J Clin Oncol Date: 2017-10-02 Impact factor: 44.544