Risk of second primary cancer among breast cancer patients: A systematic review and meta-analysis

Parynaz Parhizgar; Ayad Bahadori Monfared; Maryam Mohseny; Aliasghar Keramatinia; Seyed Saeed Hashemi Nazari; Syed Azizur Rahman; Amina Al Marzouqi; Nabeel Al-Yateem; Alireza Mosavi Jarrahi

doi:10.3389/fonc.2022.1094136

Risk of second primary cancer among breast cancer patients: A systematic review and meta-analysis

Front Oncol. 2023 Jan 17:12:1094136. doi: 10.3389/fonc.2022.1094136. eCollection 2022.

Affiliations

¹ School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Department of Social Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Prevention of Cardiovascular Disease Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
⁵ Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
⁶ Cancer and Epidemiology Research Center, West Asia Organization for Cancer Prevention, Sabzevar, Iran.

Abstract

Objectives: The aim of this study was to estimate the extra risk of second primary cancer among breast cancer patients.

Methods and materials: This is a systematic review. A comprehensive search of literature was performed in PubMed, Web of Science, Cochrane library, and Scopus. The search included all published studies up to October 2022. This systematic review included studies published in the English language that reported the risk of second primary non-breast cancer [i.e., standardized incidence ratio (SIR)] among breast cancer patients older than 15 years. After evaluating the methodological quality of the selected studies, SIRs were pooled with consideration of heterogeneity among studies. The estimates were pooled by age and time since the diagnosis of primary breast cancer for both sexes (male and female). Age was categorized based on before 50 years and after 50 years, and time was categorized as duration of less than and more than 10 years, respectively.

Results: From 2,484 articles, 30 articles were eligible for inclusion in the systematic review and meta-analysis. The studies varied in terms of population, number of cases, study design, setting, and year of implementation of the research. The estimated SIR for men and women was 1.28 (95% CI: 1.18, 1.38) and 1.27 (95% CI: 1.15, 1.39), respectively. Women diagnosed with breast cancer before menopause [SIR: 1.52 (95% CI: 1.34, 1.71) vs. 1.21 (95% CI: 1.08, 1.34)] as well as women after 10 years since their breast cancer diagnosis [1.33 (95% CI: 1.22, 1.431) vs. 1.24 (95% CI: 1.10, 1.37)] were at a higher risk of developing second primary cancer. Among men, while there were no differences in risk based on age, with the increase of time, the risk of second primary cancer was reduced [SIR: 1.22 (95% CI: 1.12, 1.33) vs. 1.00 (95% CI: 0.79, 1.22)].

Conclusion: There is an extra risk of second primary cancer among breast cancer patients. The extra risk should be considered for further screening and preventive measures among this population.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=336062, identifier (CRD42022336062).

Keywords: breast cancer; incidence; multiple primary cancer; risk; second primary cancer.

Publication types

Systematic Review

Grants and funding

The Meta-analysis internship program funded by the UOS Health Economics and Finance Research Group - University of Sharjah, Sharjah, United Arab Emirates lead to development and implementation of this research.