Surveillance of women with a personal history of breast cancer by tumour subtype. Issue 3 (March 2017) - Benveniste, A.P.
Abstract : Aim: To determine if the rate and timing of a second breast cancer event (SBCE) in women with a personal history of breast cancer varies by disease subtype or breast imaging method. Materials and methods: A retrospective review was performed of women with a SBCE from January 2006 to December 2010 at a single institution. Data analysed included oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) status of the primary and second breast cancers; mammographic and ultrasound (US) features from SBCE; and the time interval between both events. Results: Of 207 patients diagnosed with a SBCE, the median age at first diagnosis was 50.6 years, range 24.8 to 80.2; at second diagnosis was 56.2 years, range 25.8 to 87.9. Eleven percent of SBCE were diagnosed >10 years after the primary cancer diagnosis. The median time between the first and second diagnosis for ER-positive patients was 2.7 years (range 0.7–17.4 years); and 1.9 years for ER-negative patients, (range 0.4–23.4 years; p <0.002). Patients with triple-negative breast cancer (TNBC) had a shorter time between diagnoses than others ( p =0.0003). At 3, 5, and 10 years, 85%, 92%, and 97% of ER-negative and 54%, 81%, and 95% of ER-positive tumours, respectively, had recurred. ER-negative tumours and TNBC were more likely to be visible at US. Conclusion: There may be a role for customised imaging surveillance of women with a personal history of breast cancer (PHBC) after 10 years. Further studies are necessary to determine if US may be valuable in the surveillance of patients with ER-negative and TNBC tumours. Highlights: Surveillance of patients with personal history of breast cancer. Imaging surveillance by different molecular subtypes of breast cancer. Ultrasound may be valuable for surveillance in ER negative patients.