tailieunhanh - New Malignancies Following Breast Cancer

Services should be made accessible to disadvantaged women and maintain high levels of confidentiality and respect. Based on conditions of the country, specific region, or population being targeted innovative approaches to screening through self-sampling, service delivery through mobile clinics, or a combination of the two may be tested and utilized if proven effective. | Chapter 7 New Malignancies Following Breast Cancer Rochelle E. Curtis Elaine Ron Benjamin F. Hankey Robert N. Hoover BREAST Synopsis The overall risk of subsequent cancer was increased by 18 among 322 863 women diagnosed with a first primary cancer of the breast during 1973-2000 O E O 34 500 EAR 23 per 10 000 person-years . The highest cancer risks for a new cancer occurred after early-onset breast cancer ages 40 years O E EAR 71 ages 40-49 years O E EAR 38 . New primary cancers of the breast accounted for nearly 40 of all subsequent malignancies with increased risks likely reflecting hormonal genetic and other risk factors that predisposed women to the initial breast malignancy as well as intensive medical screening of the opposite breast. Genetic predisposition notably from BRCA1 2 susceptibility genes probably contributed to the pronounced excesses of subsequent breast and ovarian malignancies among younger women ages 50 years . Risks were significantly elevated for subsequent cancers of the uterine corpus which have been reported in association with the wide use of tamoxifen therapy since the early 1980s. In addition the constellation of multiple primary cancers involving the breast ovary and uterine corpus may reflect shared hormonal genetic and lifestyle factors such as nulliparity. Radiotherapy appeared to account for the observed excesses of cancers of the esophagus lung bone and soft tissues among long-term survivors while chemotherapy probably played the primary role in the elevated risk of acute non-lymphocytic leukemia. The increased risks for thyroid cancer and cutaneous melanoma after breast cancer as well as reciprocally elevated risks of breast cancer after these tumors provide clues to shared etiologic factors including genetic susceptibility . BRCA2 and melanoma . Other cancer excesses may be related to increased medical surveillance salivary gland cancer or in unusual cases misclassified metastases stomach cancer . Women with .

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