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Mortality after contralateral breast cancer in Denmark

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

How a second breast cancer diagnosis affects survival in comparison with unilateral breast cancer (UBC) is unclear. Prognostic factors for contralateral breast cancer (CBC) are also not well established. We aimed to investigate the survival pattern after CBC with particular focus on time between first and second breast cancer diagnosis and age at CBC diagnosis.

Methods

Within the nationwide Danish Breast Cancer Cooperative Group database, we identified 68,466 breast cancer patients diagnosed during 1978–2012. Patients who subsequently developed CBC were identified in a previously established database (N = 3004). Patients were followed for breast cancer-specific death in the Danish Register of Causes of Death until 2015. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard regression models. Cumulative breast cancer mortality from date of CBC was estimated using the Aalen–Johansen method.

Results

Compared with UBC patients, the rate of dying from breast cancer was more than twofold higher following a CBC diagnosis, after adjustment for age, period, tumor characteristics, and treatment of the first breast cancer (HR 2.48; 95% CI 2.31–2.66). Short time interval (< 5 years) was associated with higher breast cancer-specific mortality after CBC among patients < 70 years at CBC diagnosis compared with longer time intervals, but not among patients ≥ 70 years at CBC diagnosis.

Conclusion

Breast cancer-specific mortality rates were markedly higher after compared with before a CBC diagnosis. We found higher breast cancer-specific mortality after CBC associated with a short interval between diagnoses among patients diagnosed with CBC before age 70 years.

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Funding

This work was supported by the Scientific Committee of the Danish Cancer Society (Grant Number R90-A5792-14-S2); Henrik Henriksens Fond; Holger & Inez Petersens Mindelegat; and Fru Astrid Thaysens Legat for Lægevidenskabelig Grundforskning.

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Authors and Affiliations

  1. Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Rikke Langballe, Kirsten Frederiksen & Lene Mellemkjær

  2. Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark

    Maj-Britt Jensen & Bent Ejlertsen

  3. Department of Oncology at Rigshospitalet, Copenhagen, Denmark

    Michael Andersson & Bent Ejlertsen

  4. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark

    Deirdre Cronin-Fenton

Authors
  1. Rikke Langballe
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  2. Kirsten Frederiksen
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  3. Maj-Britt Jensen
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  4. Michael Andersson
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  5. Deirdre Cronin-Fenton
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  6. Bent Ejlertsen
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  7. Lene Mellemkjær
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Corresponding author

Correspondence to Lene Mellemkjær.

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Conflict of interest

Maj-Britt Jensen has received personal fees and non-financial support from Astra Zeneca, non-financial support from Novartis, and non-financial support from Celgene outside the submitted work. Bent Ejlertsen has received grants from NanoString, Roche, and Novartis outside the submitted work. Lene Mellemkjær has received funding for the study from funding bodies described under ‘Funding.’ All other authors declare that they have no conflict of interest.

Research involving human participants and/or animals

The study was approved by the Data Protection Board. Approvals from Ethical Committees are not needed for registry-based research in Denmark.

Informed consent

Informed consent is not required for register-based studies in Denmark that do not involve contact with study participants or biological samples.

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Langballe, R., Frederiksen, K., Jensen, MB. et al. Mortality after contralateral breast cancer in Denmark. Breast Cancer Res Treat 171, 489–499 (2018). https://doi.org/10.1007/s10549-018-4846-3

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  • DOI: https://doi.org/10.1007/s10549-018-4846-3

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