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This epidemiological and large-cohort study analyzes 248,268 female breast cancer patients from nine SEER registries (1988–2018), identifying second primary cancers occurring more than five years after initial treatment and comparing radiotherapy versus non-radiotherapy risks using Fine-Gray and Poisson regressions. Results show higher SPC incidence after radiotherapy and an overall reduction in 30-year survival when SPCs occur.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & 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question does the study address about radiotherapy and breast cancer survivors?","Question",{"text":63,"@type":64},"It evaluates whether radiotherapy increases the risk of developing second primary cancers in breast cancer survivors and quantifies the associated changes in incidence over time.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the risk of second primary cancers analyzed?",{"text":68,"@type":64},"The study analyzes 248,268 female breast cancer patients from nine SEER registries, identifies SPCs occurring more than five years after treatment, and compares radiotherapy versus non-radiotherapy cohorts using Fine-Gray and Poisson regressions.",{"name":70,"@type":61,"acceptedAnswer":71},"Which cancer types showed increased risk after radiotherapy?",{"text":72,"@type":64},"Radiotherapy increased risks for multiple SPC categories including breast, respiratory system, skin, soft tissue, eye and orbit cancers, and leukemia, while reducing risk for multiple myeloma.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},332698,1790012982,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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[homepage:](homepage: www.journals.elsevier.com/the-breast)[ www.journals.elsevier.com/the-breast](homepage: www.journals.elsevier.com/the-breast)  \n| Radiotherapy and increased risk of second primary cancers in breast cancer   survivors: An epidemiological and large cohort study\u003Cbr>Niuniu Houa,b,1, Zhe Wanga,1, Yuwei Linga,1, Guangdong Houc, Bo Zhang a, Xue Zhang a, Mei Shid, Zhuling Chu e, Yaoling Wang f, Jun Hud,**, Chong Chen b,***, Rui Linga,*\u003Cbr>a Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, 710032, China\u003Cbr>b Department of General Surgery, Xijing 986 Hospital, Fourth Military Medical University, Xi’an, China c Department of Urology, Tangdu Hospital, Fourth Military Medical University, Xi’an, 710038, China d Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi an, 710032, China e Department of General Surgery, Eastern Theater Air Force Hospital of PLA, Nanjing, China\u003Cbr>f Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, China |  |  |\n| --- | --- | --- |\n| A R T I C L E I N F O |  | A B S T R A C T |\n| Keywords:\u003Cbr>Breast cancer\u003Cbr>Second primary cancer Radiotherapy\u003Cbr>Cumulative incidence Radiotherapy-related risk Standardized incidence ratio |  | Background: Radiotherapy (RT) for breast cancer (BC) may raise the risk of second primary cancers (SPCs), a relationship inadequately studied.\u003Cbr>Methods: We analyzed 248268 female BC patients from 9 SEER registries, 1988–2018, identifying SPCs >5 years after initial treatment, comparing SPC risks between RT and non-RT cohorts using Fine-Gray and Poisson regressions.\u003Cbr>Results: Of all participants, 55.4 % received surgery and RT. The RT group had a higher SPC incidence, with excess incidence significantly dropped from 6.9 % in 1990 to 0.2 % in 2012. The 30-year SPC incidence was 24.69 % in the RT cohort and 18.11 % in the NRT cohort. RT increased the risk of SPCs(HR, 1.29 [95% CI,1.26–1.33]; P \u003C 0.001), BC(HR, 1.58[1.52–1.64]; P \u003C 0.001), cancer of respiratory system(HR, 1.21 [1.13–1.30]; P = 0.013), skin cancer(HR, 1.26[1.10–1.44]; P \u003C 0.001), leukemia(HR, 1.30[1.11–1.54]; P = 0.001), soft tissue cancer(HR, 1.78[1.34–2.37]; P \u003C 0.001), and eye & orbit cancer(HR, 2.21[1.02–4.80]; P = 0.044), except for reducing the risk of multiple myeloma (HR 0.76). Notably, RT-related risks(RR) for BC declined with increasing age and the year of BC diagnosed, increased with longer latency, but the dynamic RR for cancer of respiratory system presented the almost opposite trends. The RT cohort had higher standardized incidence ratios for SPCs compared to both the NRT cohort and the general population overall. Although 15-year overall survival for SPCs was similar between RT and NRT cohorts, SPC presence significantly lowered 30-year survival from 35.64 % to 23.90 %.\u003Cbr>Conclusions: RT might increase susceptibility to SPC in breast, respiratory system, skin, soft tissue, eye and orbit, and leukemia in BC survivors. Efforts should be made to timely diagnose SPCs based on their specific patterns to improve patient’s quality of life. |\n\n1. Background  \nBreast cancer (BC) stands as the foremost contributor to cancerrelated illness, impairment, and fatality among women on a global  \nscale [1]. Medical and surgical advancements in the past few decades have significantly improved the survival rates of BC patients. Subsequent malignancies in cancer survivors now make up 18 % of all cancer diagnoses in the US SEER cancer registries, ranking as the third most  \nAbbreviations: RT, Radiotherapy; SPCs, Second primary cancers; BC, Breast cancer; NRT, No-radiotherapy; HRs, Hazard ratios; CIs, Confidence intervals; PSM, Propensity score matching; RRs, Relative risks; SIR, Standardized incidence ratio.  \n* Corresponding ","cbCairxjSHDnUUTt","https://ap.wps.com/l/cbCairxjSHDnUUTt","pdf",6117701,"English","# Background\n# Methods\n# Results\n# Conclusions","[{\"question\":\"What question does the study address about radiotherapy and breast cancer survivors?\",\"answer\":\"It evaluates whether radiotherapy increases the risk of developing second primary cancers in breast cancer survivors and quantifies the associated changes in incidence over time.\"},{\"question\":\"How was the risk of second primary cancers analyzed?\",\"answer\":\"The study analyzes 248,268 female breast cancer patients from nine SEER registries, identifies SPCs occurring more than five years after treatment, and compares radiotherapy versus non-radiotherapy cohorts using Fine-Gray and Poisson regressions.\"},{\"question\":\"Which cancer types showed increased risk after radiotherapy?\",\"answer\":\"Radiotherapy increased risks for multiple SPC categories including breast, respiratory system, skin, soft tissue, eye and orbit cancers, and leukemia, while reducing risk for multiple myeloma.\"}]","Radiotherapy and increased risk of second primary cancers in breast cancer survivors - An epidemiological and large cohort study | PDF",1789999114,25]