University of Twente Student Theses
The risk of developing lung cancer after breast cancer
Nagtegaal, Sophie (2025) The risk of developing lung cancer after breast cancer.
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| Abstract: | Background: Second primary lung cancer (SPLC) is a serious long-term complication among breast cancer survivors, with limited knowledge on how treatment characteristics influence this risk. This study aimed to assess associations between breast cancer treatments and SPLC risk, and to compare tumor characteristics of SPLCs in breast cancer survivors with those of primary lung cancer in women without a history of cancer. Methods: All women newly diagnosed with breast cancer between 2005 and 2020 were selected from the Netherlands Cancer Registry. Breast cancer patients were grouped into four cohorts based on year of diagnosis and cancer being either invasive or in situ. Multivariate logistic regression, Cox proportional hazards models, and a competing risk Cox model were used to assess associations between patient, tumor, and treatment characteristics and the risk of SPLC. In addition, all women diagnosed with primary lung cancer or SPLC between 2010 and 2023 were selected to compare tumor characteristics between SPLCs and primary lung cancers. Lung tumor characteristics were compared between breast cancer survivors with SPLC and women diagnosed with a primary lung tumor without a history of cancer. Results: Increased risk of SPLC was observed among women aged 50-74 years compared to those under 50 years, although this association was not consistent for patients aged 75+. Lower socioeconomic status and HR-/HER2- breast tumor receptor status were linked to higher risk of SPLC, while stage III breast tumors and multifocal breast tumors were associated with decreased risk. In the 2010-2020 invasive cohort, radiotherapy and chemotherapy were associated with reduced risk of SPLC. These findings were largely confirmed in Cox regression. The competing risk Cox model confirmed that older patients had higher mortality before SPLC, highlighting the importance of accounting for competing events. Compared to women with primary lung cancer, SPLCs in breast cancer survivors were more frequently located in the upper lobe and diagnosed at an earlier stage. Conclusion: This study shows that certain patient characteristics, breast tumor characteristics, and treatment characteristics are associated with the risk of developing SPLC in breast cancer survivors. Differences were found in tumor location and stage at diagnosis between SPLCs and primary lung cancers. |
| Item Type: | Essay (Master) |
| Clients: | IKNL |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/106621 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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