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Survival of women diagnosed with breast cancer and who have survived a previous cancer

  • Epidemiology
  • Published:
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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.

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Data availability

This study used SEER-MEDICARE data. The Centers for Medicare and Medicaid Services do not allow the redistribution of their data by researchers. SEER-MEDICARE data are distinct from the publicly available SEER database, and can be obtained by researchers, by following the process described on https://healthcaredelivery.cancer.gov/seermedicare/obtain/requests.html (access requirements include Institutional Review Board approval and the completion of a Data Use Agreement).

Code availability

Available upon request.

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Acknowledgements

The authors also acknowledge the efforts of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database. Contents of this paper are solely the responsibility of the authors and do not necessarily represent the official view of the NIH.

Funding

This work was supported by the National Cancer Institute (NCI) (R01CA229834-02 to SLP and K24CA201543 to DEG).

Author information

Authors and Affiliations

  1. Department of Population & Data Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9066, USA

    Sandi L. Pruitt, Hong Zhu, Daniel F. Heitjan, Bhumika Maddineni, Anna Tavakkoli, Ethan A. Halm, David E. Gerber, Danyi Xiong & Caitlin C. Murphy

  2. Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA

    Sandi L. Pruitt, Hong Zhu, Asal Rahimi, Anna Tavakkoli, Ethan A. Halm, David E. Gerber & Caitlin C. Murphy

  3. Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Anna Tavakkoli, Ethan A. Halm & David E. Gerber

  4. Department of Statistical Science, Southern Methodist University, Dallas, TX, USA

    Daniel F. Heitjan & Danyi Xiong

  5. Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Asal Rahimi

Authors
  1. Sandi L. Pruitt
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Contributions

All authors contributed to the study conception and design. Data analysis was performed by BM. The first draft of the manuscript was written by SP and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sandi L. Pruitt.

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Conflict of interest

DH reports consulting for Braintree Labs, Creatics LLC, Abbott Labs, and Macrogenics, Inc., and legal consulting for Noven and Women’s Talc Project; AR reports consulting and advisory board for Hologic and research grant and educational speaker for Accuray; and DEG reports research funding from Astra-Zeneca, BerGenBio, and Karyopharm, Gilead stock ownership and consulting for Samsung Bioepis and Catalyst Pharmaceuticals. SLP, HZ, BM, DX, AT, EAH, and CCM have no disclosures.

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Pruitt, S.L., Zhu, H., Heitjan, D.F. et al. Survival of women diagnosed with breast cancer and who have survived a previous cancer. Breast Cancer Res Treat 187, 853–865 (2021). https://doi.org/10.1007/s10549-021-06122-w

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  • DOI: https://doi.org/10.1007/s10549-021-06122-w

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