You Decide

  I came across a remarkable 25 year retrospective cohort study (more here to understand the strength of this study type) from the University of Cambridge that highlights the risk of developing secondary primary cancers in breast cancer survivors. I share this information as it can highlight the ongoing need for preventative screenings, even after fighting breast cancer, but I also appreciate the sensitive nature of knowing more than needed when you’re already dealing with so much. This is why I am providing this preface and encouraging anyone who reads on to decide for themselves. This may be a post best returned to at a later date, if you wish. 

You decide. 

Quoted from article material is in black. My thoughts are in pink. 

Setting the stage. 

This study analyzed data from over 580,000 female and over 3,500 male breast cancer survivors diagnosed between 1995 and 2019 using the National Cancer Registration Dataset.

These are their findings as summarized by Becker’s Hospital Review.

1. Women who survived breast cancer had double the risk of contralateral breast cancer as the general population, and they were at 87% greater risk of endometrial cancer, 58% higher risk of myeloid leukemia and 25% greater risk of ovarian cancer. This one makes me think. All through my treatment, we’ve discussed recurrence rates of current cancer, but not necessarily potential of new primary cancer in the contralateral (other side) breast. This just increases my awareness of living a healthy lifestyle and needing ongoing preventative screenings to find any possible cancer early enough to be treated. It doesn’t change what’s in store for me now so it doesn’t personally make me go on doomsday thinking. An important addition from another summary of the article: One potential explanation is that a larger number of younger breast cancer survivors may have inherited genetic alterations that increase risk for multiple cancers. For example, women with inherited changes to the BRCA1 and BRCA2 genes are at increased risk of contralateral breast cancer, ovarian and pancreatic cancer. In my case, I do not fall into that category. I have negative genes all around. At least the ones we currently know about. 
2. Women diagnosed with breast cancer before age 50 were 86% more likely to develop a second primary cancer, whereas women diagnosed after age 50 had a 17% increased risk. I’m more at risk than others may be. I also will likely live longer given my current age which provides more time for other primary cancers to grow. Good to know. 
3. Women from more socioeconomically disadvantaged backgrounds were at a 35% higher risk of second primary cancer compared to those from less deprived backgrounds. The difference was driven by non-breast cancer risks, particularly for lung, kidney, head and neck, bladder, esophageal and stomach cancers. I have thought about this every step of the way. The Joint Commission has a National Patient Safety Goal for Social Determinants of Health (SDOH). This is why.
4. Male breast cancer survivors were 55 times more likely to develop contralateral breast cancer compared to the general male population. Likely an unknown fact.
5. Male breast cancer survivors were 58% more likely to develop prostate cancer. More reasons for preventative screening and trending Prostate-Specific Antigen (PSA) lab tests.
6. About 3 in every 100 men diagnosed with breast cancer at age 50 or older developed contralateral breast cancer during a 25-year period. Another likely unknown fact. 

Here is a link to another summary and then finally, the actual research article, in case anyone is interested.  

Now replace sadness with cancer and you’ll understand a bit more how I feel.