Incidence and temporal patterns of true recurrences and second primaries in women with breast cancer: A 10-year competing risk-adjusted analysis

Introduction: We report a population-based, competing risk-adjusted analysis of the risk and timing of true recurrences and second primaries in women with breast cancer (BC), that are still ill-defined. Methods: We performed a manual review of medical charts of 1988 BC patients from a cancer registr...

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Main Authors: Silvia Mancini, Lauro Bucchi, Annibale Biggeri, Orietta Giuliani, Flavia Baldacchini, Alessandra Ravaioli, Federica Zamagni, Fabio Falcini, Rosa Vattiato
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Breast
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Online Access:http://www.sciencedirect.com/science/article/pii/S0960977625000128
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author Silvia Mancini
Lauro Bucchi
Annibale Biggeri
Orietta Giuliani
Flavia Baldacchini
Alessandra Ravaioli
Federica Zamagni
Fabio Falcini
Rosa Vattiato
author_facet Silvia Mancini
Lauro Bucchi
Annibale Biggeri
Orietta Giuliani
Flavia Baldacchini
Alessandra Ravaioli
Federica Zamagni
Fabio Falcini
Rosa Vattiato
author_sort Silvia Mancini
collection DOAJ
description Introduction: We report a population-based, competing risk-adjusted analysis of the risk and timing of true recurrences and second primaries in women with breast cancer (BC), that are still ill-defined. Methods: We performed a manual review of medical charts of 1988 BC patients from a cancer registry in northern Italy (2000–2013). The occurrence and timing of true recurrences (TRs, including local, regional and distant recurrences) and second BCs (SBCs, including ipsilateral and contralateral SBC) during 10 years of follow-up were evaluated. The prognostic factors for TRs and SBCs were identified using the Fine and Gray model. Results: The cumulative incidence was 13.7 % (95 % confidence interval (CI), 12.2–15.3 %) for TRs and 4.6 % (95 % CI, 3.7–5.7 %) for SBCs. The median time to detection varied between 3.4 (TRs) and 5.1 (SBCs) years. The risk of TRs had two peaks, one between the 2nd and the 3rd year of follow-up and another between the 7th and the 8th year. The subhazard of SBCs fluctuated for five years, had a drop between the 6th and the 7th year and a marked peak between the 8th and the 9th year. Prognostic factors for TRs (tumour stage and grade, lymph node status and residual disease) and SBCs (patient age and –inverse association– hormone therapy) were different. In the 9th-10th year of follow-up, the excess incidence of total BC episodes as compared with the expected incidence of BC was no longer significant (standardised incidence ratio, 1.15; 95 % CI, 0.86–1.53). Conclusions: The multifaceted results of this study warrant further research into the risk and timing of all types of BC recurrence.
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spelling doaj-art-76e0cb6bd56d4173981503c8349dd5732025-01-31T05:10:10ZengElsevierBreast1532-30802025-04-0180103883Incidence and temporal patterns of true recurrences and second primaries in women with breast cancer: A 10-year competing risk-adjusted analysisSilvia Mancini0Lauro Bucchi1Annibale Biggeri2Orietta Giuliani3Flavia Baldacchini4Alessandra Ravaioli5Federica Zamagni6Fabio Falcini7Rosa Vattiato8Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, ItalyEmilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy; Corresponding author.Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, ItalyEmilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, ItalyEmilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, ItalyEmilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, ItalyEmilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, ItalyEmilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy; Cancer Prevention Unit, Local Health Authority, Forlì, ItalyEmilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, ItalyIntroduction: We report a population-based, competing risk-adjusted analysis of the risk and timing of true recurrences and second primaries in women with breast cancer (BC), that are still ill-defined. Methods: We performed a manual review of medical charts of 1988 BC patients from a cancer registry in northern Italy (2000–2013). The occurrence and timing of true recurrences (TRs, including local, regional and distant recurrences) and second BCs (SBCs, including ipsilateral and contralateral SBC) during 10 years of follow-up were evaluated. The prognostic factors for TRs and SBCs were identified using the Fine and Gray model. Results: The cumulative incidence was 13.7 % (95 % confidence interval (CI), 12.2–15.3 %) for TRs and 4.6 % (95 % CI, 3.7–5.7 %) for SBCs. The median time to detection varied between 3.4 (TRs) and 5.1 (SBCs) years. The risk of TRs had two peaks, one between the 2nd and the 3rd year of follow-up and another between the 7th and the 8th year. The subhazard of SBCs fluctuated for five years, had a drop between the 6th and the 7th year and a marked peak between the 8th and the 9th year. Prognostic factors for TRs (tumour stage and grade, lymph node status and residual disease) and SBCs (patient age and –inverse association– hormone therapy) were different. In the 9th-10th year of follow-up, the excess incidence of total BC episodes as compared with the expected incidence of BC was no longer significant (standardised incidence ratio, 1.15; 95 % CI, 0.86–1.53). Conclusions: The multifaceted results of this study warrant further research into the risk and timing of all types of BC recurrence.http://www.sciencedirect.com/science/article/pii/S0960977625000128Breast cancerFollow-upRecurrenceSecond breast cancer
spellingShingle Silvia Mancini
Lauro Bucchi
Annibale Biggeri
Orietta Giuliani
Flavia Baldacchini
Alessandra Ravaioli
Federica Zamagni
Fabio Falcini
Rosa Vattiato
Incidence and temporal patterns of true recurrences and second primaries in women with breast cancer: A 10-year competing risk-adjusted analysis
Breast
Breast cancer
Follow-up
Recurrence
Second breast cancer
title Incidence and temporal patterns of true recurrences and second primaries in women with breast cancer: A 10-year competing risk-adjusted analysis
title_full Incidence and temporal patterns of true recurrences and second primaries in women with breast cancer: A 10-year competing risk-adjusted analysis
title_fullStr Incidence and temporal patterns of true recurrences and second primaries in women with breast cancer: A 10-year competing risk-adjusted analysis
title_full_unstemmed Incidence and temporal patterns of true recurrences and second primaries in women with breast cancer: A 10-year competing risk-adjusted analysis
title_short Incidence and temporal patterns of true recurrences and second primaries in women with breast cancer: A 10-year competing risk-adjusted analysis
title_sort incidence and temporal patterns of true recurrences and second primaries in women with breast cancer a 10 year competing risk adjusted analysis
topic Breast cancer
Follow-up
Recurrence
Second breast cancer
url http://www.sciencedirect.com/science/article/pii/S0960977625000128
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