Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Epidemiological studies of risk factors for second primary breast cancer (SBC) have been conducted primarily in non-Hispanic White (NHW) women. METHODS: A racially and ethnically diverse population-based pooled cohort of 9639 women with first primary stage I-III invasive breast cancer (FBC) was linked with the California Cancer Registry; 618 contralateral SBC (CSBC) and 278 ipsilateral SBC (ISBC), diagnosed more than 6 months after FBC, were identified. Using Fine and Gray models accounting for competing risks, we assessed associations of CSBC and ISBC risk with FBC clinical characteristics and epidemiological factors. RESULTS: In younger women (FBC at age <50 years), higher CSBC risk was associated with ER/PR-negative FBC (hazard ratio [HR] = 1.68), breast cancer family history (HR = 2.20), and nulliparity (HR = 1.37). In older women (FBC at age ≥50 years), higher risk was associated with breast cancer family history (HR = 1.32), premenopausal status (HR = 1.49), overweight (HR = 1.39), and higher alcohol consumption (HR = 1.34). For ISBC, higher risk was associated with married status (HR = 1.94) in younger women, and overweight (HR = 1.60) among older women. For CSBC, HR estimates were generally similar across racial and ethnic groups. Even after adjustment for these risk factors, compared with NHW women, risk remained elevated for CSBC in younger African American, Asian American, and Hispanic women, and for ISBC in older African American and Hispanic women with ER/PR-positive FBC. CONCLUSIONS: Our findings support genetic risk evaluation, enhanced screening, and lifestyle changes in women at higher risk of SBC. Additional risk factors must contribute to the unequal burden of SBC across racial and ethnic groups.
DOI: 10.1093/jnci/djae254
Institutions: Stanford Medicine, Stanford Cancer Institute, Stanford University, University of Southern California, USC Norris Comprehensive Cancer Center, UC Davis Comprehensive Cancer Center, University of California, Davis, University of California, San Francisco, UCSF Helen Diller Family Comprehensive Cancer Center, Kaiser Permanente, Kaiser Permanente Northern California, City of Hope, Beckman Research Institute, Zero Breast Cancer
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: U.S. Department of Defense, California Breast Cancer Research Program, California Department of Public Health, University of Southern California, Fred Hutchinson Cancer Research Center, Wayne State University, University of Pennsylvania, Emory University, Cancer Registry of Greater California, Barbara Ann Karmanos Cancer Institute, Ministerio de Economía y Competitividad, National Institutes of Health, Centers for Disease Control and Prevention, University of California, San Francisco, National Cancer Institute, National Institute of Child Health and Human Development, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1253072103, G1352184354, G1395202410, G1554522753, G1603297369, G1788825155, G1911961208, G2089898225, G2326769315, G2337224928, G2342729008, G2419028985, G248592502, G2612351997, G2618743638, G2632388646, G2683002635, G3040535851, G3226861515, G326542470, G3448447748, G3467199957, G3509688676, G3632360174, G3881781645, G4180557805, G4227175859, G4231487388, G429713427, G4332884407, G4428815567, G4450071017, G4656581887, G4712798043, G4814478413, G4854421162, G5003484623, G504639888, G512654018, G5177226045, G5206193551, G5305488713, G5631299761, G5821893214, G5994213499, G6044614810, G6368518044, G6659231666, G671936517, G6951404960, G6996347837, G7018858328, G7087603865, G7151768789, G7290139498, G7705257630, G7884669440, G7978929429, G7979917349, G804659861, G8083727551, G819947437, G8380263711, G8509442309, G8675407700, G9000346670, G908924418, G946791773
OpenAlex ID: W4403335226