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조회584

김하경Hakyoung Kim

동국대학교 일산병원

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JAMA Netw. Open, Sep 05 2023, 6 (9) | https://doi.org/10.1001/jamanetworkopen.2023.33557 Survival After Development of Contralateral Breast Cancer in Korean Patients With Breast Cancer.

Hakyoung Kim, MD¹; Tae In Yoon, MD²; Seonok Kim, MSc³; Sae Byul Lee, MD, PhD⁴; Jisun Kim, MD, PhD⁴; Il Yong Chung, MD, PhD⁴; Beom Seok Ko, MD, PhD⁴; Jong Won Lee, MD, PhD⁴; Byung Ho Son, MD, PhD⁴; Sungchan Gwark, MD, PhD⁵; Jeong Kyeung Kim, MD⁶; Hee Jeong Kim, MD, PhD⁴

¹Department of Surgery, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea

²Division of Breast Surgery, Department of Surgery, Dongnam Institute of Radiological and Medical Science, Busan, Republic of Korea

³Department of Clinical Epidemiology and Biostatistics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea

⁴Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea

⁵Department of Surgery, Ewha Woman’s University College of Medicine, Ewha Woman’s University Mokdong Hospital, Seoul, Republic of Korea

⁶Maria Breast Clinic, Daegu, Republic of Korea

Corresponding Author: Hee Jeong Kim, MD, PhD

Abstract

Contralateral breast cancer (CBC) is the most frequently diagnosed primary cancer in patients with breast cancer. Although many studies have reported survival after the development of CBC, results have been inconsistent. To investigate whether the development of CBC is associated with survival among patients with breast cancer. This cohort study was conducted at the Asan Medical Center, Korea, among patients who were diagnosed with primary unilateral, nonmetastatic, stage 0 to III breast cancer between 1999 and 2013 and followed up through 2018. The median (IQR) follow-up was 107 (75-143) months. Patients were categorized into CBC and no-CBC groups by whether they developed CBC during the follow-up period. Data were analyzed from November 2021 to March 2023. Development of CBC. Survival rates of CBC and no-CBC groups were compared using a time-dependent Cox proportional hazard model in the entire study population and in subgroup analyses by interval of CBC development and subtype of the primary breast cancer. Among 16 251 patients with breast cancer (all Asian, specifically Korean; mean [SD] age, 48.61 [10.06] years), 418 patients developed CBC. There was no significant difference in overall survival between CBC and no-CBC groups (hazard ratio, 1.166; 95% CI, 0.820-1.657). Patients who developed CBC within 1.5 years after the surgery of the primary breast cancer had a higher risk for overall death during the study period (hazard ratio, 2.014; 95% CI, 1.044-3.886), and those who developed CBC after 1.5 years showed no significant difference in survival compared with the no-CBC group. Patients with hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (ERBB2, formerly HER2)-negative breast cancer had a higher risk for overall death in the CBC group (hazard ratio, 1.882; 95% CI, 1.143-3.098) compared with the no-CBC group. This study found that development of CBC in patients with breast cancer was not associated with survival but that early development of CBC after diagnosis of the primary breast cancer or development of CBC in patients with HR-positive/ERBB2-negative breast cancer was associated with survival. These results may provide valuable information for patients seeking advice on opting for contralateral prophylactic mastectomy.

논문정보

형식Research article
게재일2023년 09월 (BRIC 등록일 2023-09-18)
연구진국내 연구진
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