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Tumor stage affects risk and prognosis of contralateral breast cancer: results from a large Swedish-population-based study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
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2012 (English)In: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 30, no 28, 3478-3485 p.Article in journal (Refereed) Published
Abstract [en]


The number of breast cancer survivors at risk of developing contralateral breast cancer (CBC) is increasing. However, ambiguity remains regarding risk factors and prognosis for women with CBC.


In a cohort of 42,670 women with breast cancer in the Uppsala/Örebro and Stockholm regions in Sweden in 1992 to 2008, we assessed risk factors for and prognosis of metachronous CBC by using survival analysis. Breast cancer-specific survival for women with CBC was evaluated and compared with results for women with unilateral breast cancer (UBC) by using time-dependent Cox-regression modeling.


An increased risk for CBC was observed among women who had primary breast cancer with ≥ 10 involved lymph nodes compared with node-negative women (adjusted hazard ratio [HR], 1.8; 95% CI, 1.2 to 2.7). The prognosis was poorer in women with CBC than with UBC. The hazard of dying from breast cancer was especially high for women with a short interval time to CBC (adjusted HR, 2.3; 95% CI, 1.8 to 2.8 for CBC diagnosed ≤ 5 years v UBC) and gradually decreased with longer follow-up time but remained higher than the hazard originating from the primary tumor for ≥ 10 years.


Women with advanced-stage primary breast cancer had an increased risk of developing CBC. CBC is associated with an increased risk of dying from breast cancer throughout a long period of follow-up after the primary tumor. Our findings suggest that the event of CBC marks a new clinical situation in terms of investigations for metastases, treatment considerations, and follow-up strategy.

Place, publisher, year, edition, pages
2012. Vol. 30, no 28, 3478-3485 p.
Keyword [en]
Age Distribution, Aged, Aged; 80 and over, Breast Neoplasms/diagnosis/*mortality/pathology/*therapy, Confidence Intervals, Databases; Factual, Female, Humans, Middle Aged, Neoplasm Staging, Survival Analysis, Sweden/epidemiology
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-182966DOI: 10.1200/JCO.2011.39.3645ISI: 000309517700012PubMedID: 22927521OAI: oai:DiVA.org:uu-182966DiVA: diva2:561584
Available from: 2012-10-19 Created: 2012-10-19 Last updated: 2012-11-12Bibliographically approved

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