More targeted cancer prevention and early detection strategies needed in breast cancer survivorship

A new study finds breast cancer survivors in general have higher risk of new cancer diagnosis compared to healthy individuals. The article, which appears in Cancer, states that compared to the general population in the United States, the risk of new cancer diagnoses among survivors was 20% higher for those with hormone receptor (HR) positive cancers and 44% higher for those with HR-negative cancers.

Breast cancer is the most commonly diagnosed and prevalent cancer among women in the U.S., with over 3.9 million living breast cancer survivors as of 2019. The number of survivors is expected to increase with the aging population and advances in breast cancer treatment.

Subsequent primary cancer (SPC) after breast cancer is a well-known late effect, but the risk by breast cancer subtype and age at diagnosis was largely unknown except for contralateral breast, lung, and ovarian cancers. This study, led by Hyuna Sung, Ph.D., is the first to examine the risk of a range of SPCs including 26 types, and evaluate the risk by tumor subtypes and diagnosis age of breast cancer. This study included women (aged 20 to 84 years) diagnosed with invasive breast cancer from 1992-2015 and who survived for a year or more.

"With most women living decades after a breast cancer diagnosis, it is important to identify survivors at higher risk for future cancers and provide tailored recommendations for risk reduction and early detection," said Dr. Sung.

Data show that the risk differs by survivor characteristics, such as breast cancer subtypes and their diagnosis age. For example, several cancers including subsequent breast cancer, acute nonlymphocytic leukemia, ovarian cancer, and lung cancer are more likely to develop after HR-negative cancer than after HR-positive cancer. Women who were first diagnosed with breast cancer before age 50 also have greater risk for subsequent cancer than women with later onset breast cancer.

"Differential risk of subsequent cancer according to survivor characteristics highlights that more targeted approaches for cancer prevention and early-detection strategies are needed in survivorship care planning to mitigate the burden of subsequent cancers in the growing population of survivors," said the authors.