Early detection of secondary breast malignancies among female cancer survivors

As of January 2012, about 13.7 million American people were living with cancer, and that number will grow to almost 18 million by 2022. There is no cancer screening guideline developed specifically for cancer survivors, although they had a 14% higher risk of developing a new malignancy than the general population. Cancer survivors' first malignancy were usually surveillanced closely, but screening for other cancer sites was not prescribed, especially when patients did not fall into the age/risk groups defined by the general cancer screening guidelines. This study compared the stage of secondary breast cancer at the time of diagnosis among female cancer survivors by the first cancer site and age groups. In the SEER data, 86,709 women were diagnosed with secondary breast cancer at least two months following the first cancer diagnosis during 1973-2010. Among breast cancer survivors, 59% (younger than 40), 64% (age 40-49), 72% (age 50-75), and 71% (age 76 and older) have their secondary breast cancer diagnosed at stage 0 or I. Among survivors, whole first malignancies were not breast cancer; the percentages are only 48% (younger than 40), 49% (age 40-49), 65% (age 50-75), and 61% (age 76 and older); among these survivors already died from known causes, 71% (younger than 40), 57% (age 40-49), 30% (age 50-75), and 20% (age 76 and older) died from breast cancer. The benefit of cancer screening is not borne equally among all cancer survivors. Patients whose first malignancies were not breast cancer, especially young patients, need tailored screening strategies.