Clinical Features And Prognosis Analysis Of Patients With Breast Cancer And Multiple Primary Malignant Neoplasms

BackgroundBreast cancer is the most common malignancy in women worldwide.In China,the incidence of breast cancer is on the rise,but the prognosis is good compared with other tumors.Advances in treatments such as molecular targeted therapy and endocrine therapy have improved the survival and prognosis of breast cancer survivors.In addition,with the advancement of medicine and the increase of average human life expectancy,more and more cancer patients can be timely detected in the follow-up of the second primary tumor.The breast is the most common site for multiple primary malignant neoplasms in women,and the incidence of breast cancer with multiple primary malignant neoplasms has been increasing in recent years.The clinical features and prognostic factors affecting breast cancer with multiple primary malignant neoplasms have been inconsistently described,and there are relatively few studies of breast cancer with multiple primary malignant neoplasms.ObjectiveThe purpose of this study was to analyze the clinical characteristics and prognosis of patients with breast cancer and multiple primary malignant neoplasms,to investigate the factors affecting their prognosis,and to provide reference for clinical treatment.MethodsClinical data of 123 patients with breast cancer and multiple primary malignant tumors admitted to Nanfang Hospital of Southern Medical University from January 2008 to April 2022 were collected,and their clinical characteristics were statistically described.Among the 123 patients,66 patients were screened out for survival analysis in the included prognostic analysis group.Kaplan-Meier method was used to calculate the survival rate and Log-rank test was used to compare and analyze the differences in survival curves under different clinical characteristics.Cox proportional risk model was used for univariate and multivariate analysis of prognosis.P<0.05 was considered statistically significant.ResultsFrom January 2008 to April 2022,a total of 56093 patients with primary malignant tumors were admitted to Nanfang Hospital of Southern Medical University,including 7960 patients with breast cancer,accounting for 1.43%.Among the 7960 cases of breast cancer,123 cases were multiple primary malignancies,accounting for 1.55%.Among the 123 patients with breast cancer and multiple primary malignancies,110 had double primary cancer,13 had triple primary cancer,and 25 had a family history of tumor.The median age of the first primary tumor was 48 years and the median age of the second primary tumor was 52 years,the age of onset was mainly in the age group of 40-60 years old.Among them,86 patients had accurate tumor intervals,31 patients(36.0%)had simultaneous multiple primary malignant neoplasms,and 55 patients(64%)had heterogeneous multiple primary malignant neoplasms.79.1%of the patients with breast cancer and multiple primary malignant neoplasms had a tumor interval of less than 5 years.Among all the sites with multiple primary malignant neoplasms,breast cancer accounted for the most(49.4%),followed by digestive system tumors(12.4%)and head and neck tumors(11.6%).At present,the most widely used treatment methods for multiple primary malignant tumors are surgery and chemotherapy.The cumulative survival rates at 12 months,24 months,36 months and 60 months were 93.75%,90.00%,84.93%and 70.27%,respectively,in 66 patients with breast cancer and multiple primary malignant neoplasms included in prognostic analysis.There was a significant difference in survival between last tumor stage(P=0.0012)and radical surgery(P<0.0001).The last clinical stage of tumor(stage Ⅲ-Ⅳ)(P=0.016)was a risk factor for prognosis,and radical surgery(P=0.0009)was a protective factor for prognosis.ConclusionThe peak age of breast cancer with multiple primary malignant neoplasms is 40 to 60 years old.Breast cancer patients should pay attention to the screening of the second primary tumor,especially within 3 years after the diagnosis of the first primary tumors,,and pay attention to the screening of digestive system tumors and head and neck tumors.Late clinical stage of the last tumor(stage Ⅲ-Ⅳ)is a risk factor for prognosis,and radical surgery is a protective factor for prognosis.