How common is a 2nd cancer in other breast?
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Hello! I am recently diagnosed with a recurrence of breast cancer , both in right breast. 13 1/2 years ago it was DCIS. I had surgery and radiation and tamoxifen for 5 yrs. Now in the same breast I have a 14 mm invasive ductal carcinoma with 1 lymph node testing positive. I was told I was a candidate for another lumpectomy and re radiation. Genetic tests are negative. When I went for my pre op visit I asked the surgeon for statistics on recurrence with this treatment and he said it is unknown. That there have been a few very small studies done.
Is anyone familiar with re radiation of same breast and results.
So I went back to my radiation oncologist who treated me in the past to ask if he agreed with this treatment. His answer was a firm no. His recommendation is a mastectomy. Has anyone else faced making this decision?
Thank you!
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Hi Mermaidmamacita-
We want to welcome you to BCO, although we're so sorry you find yourself here. You may want to try posting in our Just Diagnosed with a Recurrence forum, members there may be able to answer your questions about radiation on the same breast after a recurrence: https://community.breastcancer.org/forum/106
The Mods
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Hi all,
I'm not sure what the stats are but I was surprised when my BCN told me that I was more likely to get a second one than somebody who had never had BC was to get their first one!
Needless to say I have a second primary on the other side 10 years after my first. However, on mastectomy, they have only found 30mm of DCIS and not found the invasive yet, although I have micromet in a lymph node!
Pol xx
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Rerdiation is not common. Recurrence after radiation usually is treated with mastectomy, based on all I've read
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There is a limit on how much radiation you can be intentionally given for treatment in a lifetime in various areas of the body. Sounds like your RO checked and you’re at the limit. I had rads for Hodgkin’s lymphoma 30 years ago and hit my limit then. My local BS made the call to the RO from the exam room when we were discussing my options after diagnosis. Hearing that i hadhit the limit just reinforced my decision to do BMX.
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Livinglovinglaughing- your MO makes a good point. Would you do anything with the information? There are gene mutations for other cancers besides BC that show up on genetic testing too like ovarian cancer. If it did would you be ok to have your ovaries removed prophylactically? Keep in mind there is no screening for ovarian cancer and by the time symptoms show up it’s generally stage 4 and nothing they can do. Your girls are old enough to make their own decision. You might ask them what they think about testing for you and them. Would they do anything different? If nothing else mammos more often. You never know, they may already be stressed over not knowing if there’s a genetic factor at play since you were diagnosed twice.
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Livinglovinglaughing- your MO makes a good point. Would you do anything with the information? There are gene mutations for other cancers besides BC that show up on genetic testing too like ovarian cancer. If it did would you be ok to have your ovaries removed prophylactically? Keep in mind there is no screening for ovarian cancer and by the time symptoms show up it’s generally stage 4 and nothing they can do. Your girls are old enough to make their own decision. You might ask them what they think about testing for you and them. Would they do anything different? If nothing else mammos more often. You never know, they may already be stressed over not knowing if there’s a genetic factor at play since you were diagnosed twice.
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hello,
I have had bilateral breast cancer on the left breast 1 year after the right breast. My surgeon said the probability was I/2 of 1 percent
that this would occur one year later. mine was caught early and I had lumpectomies for both. I guess we'lll call it bad luck. I am treated and
monitored at Sloan Kettering. Important to have good screenings to catch anything early unfortunately.. but you can get through it. I am now two
years out from my last cancer. good luck to all here.
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Totallytubular, how big were your both tumors? And were you already under hormonal therapy when you got the second one?
thanks
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living loving-
You ask what would you do with the results if you had BRCA testing. I tested positive for brca2 after my lumpectomy. So I did not have to consider mastectomy at the get go as standard of care for early stage Breast cancer in my area is lumpectomy. My oncologist did send me to a genetic cancer specialist at Dana Farber, and from that visit it was determined that 1. Needed ovaries out ASAP. High risk for ovarian cancer and no good screening for it. 2. Alternating MRI and diagnostic ultrasound every six months, or prophylactic dmx. I chose the screening and hope I made a good choice. 3. Colonoscopy right away and every five years after (sister recently passed from colorectal cancer). 4. Yearly dermatology appointment due to elevated risk for melanoma of the skin. 5. Yearly eye doctor appointment due to elevated risk for melanoma of the eye. Also yearly gyn appointments, although I was already doing that along with eye doctor and dermatologist.
My takeaway from knowing I am at higher risk for bc and other cancers is that for some of them you can screen and hopefully catch while treatable. My son will need to be tested so he can take appropriate measures. I wish he would do it now, But he is not very concerned until he is ready to start a family (he is 27). I did find out at Dana Farber that if my son and his wife both carry the BRCA2 gene mutation, there are definetly bad consequences for biological children they may have, although apparently there is medical intervention they could do to prevent these consequences
I think knowledge is power. We cannot fix everything, but we can screen for it, hopefully catch it early,and have a plan of action ready if it does happen.
This is what is working for me, but I would be lying if I said I do not worry or think about it all the time.
I hope this helps you in deciding how you will move forward with this. Please pm me if you want to talk more about this. I am happy to share any info that I have regarding this, although I am no expert—still a newbie
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I had my first cancer in 2000 at age 39, stage I with no node involvement and estrogen positive. I had radiation, lumpectomy, Lupron injections to reduce the estrogen, then five years of Tamoxifen. Hard to describe how agonizing it was 15 years later to develop a second, new tumor in the opposite breast, stage II and estrogen negative. That second one prompted a double mastectomy one year ago, with partial reconstruction.
Last week I found a defined lump very close the original cancer location. I've been waiting for 10 days to get in for an ultrasound to find out what it is (going on Monday morning). The breast care coordinator says it could be fat necrosis.
This is a great forum. Thank you for providing it.
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I was diagnosed with bilateral breast cancer, both primaries. 1 ER+PR- HER2+ and 2 lymph nodes with extranodal extension Ki-67 20%; the other was ER+PR+ HER2- no lymph involvement Ki-67 5%. There were also other areas of involvement in both breasts that would require many more biopsies, so I opted for BMX.
My first radiologist missed the 2nd breast, I went for a 2nd opinion because I wanted to be sure it was cancer, and the 2nd radiologist found the tumor in my other breast. They are both Grade II stage 2B. Both were confirmed by needle core biopsies at the same time.
It is my personal opinion that this doubles my recurrence rate and any systemic treatment gives me double benefit. I opted for chemo against my MO's opinion.
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Carm,
Ditto! I think its more common than they say it is. I was dx SBBC at the start...I chose chemo too. They said my risk was only based on the "worst side" but I don't believe the other side does not add to the risk at all.
Gully
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would be fascinating to get stats on how many women following a lumpectomy did NOT have a recurrence for 10 years..
Please let me know if you know anything about below research for recurrences:
Another very interesting area my RO's research (RO in Vancouver) is into blood tests for early cancer DNA. Not the same as tumor marker tests, but simpler and could only cost $150. I will ask him about this and if it could be used to identify early BC recurrence:
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Carm, I think you made a wise decision.
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Hi all. In mid February I was diagnosed with Stage 1 IDC in right breast. This was a second primary breast cancer after 21 years. Triple negative/Ki67 23%/onca DX 51. 1 cm/ node negative. In 1996, I had a lumpectomy left breast. That was Stage 1/1.9 cm/node negative/ER-,PR- Herceptin was not tested at that time. I then did 5 months of AC and 33 rounds of radiation. It was a clinical trial that used double dose of A and quadruple dose of C. One month ago I had a bilateral mastectomy with reconstruction. On May 3, I will have my first chemo round. TCx4. At this point, of course I’m regretting not doing a bilateral mastectomy 21 years ago. Everyone has to make their own choice. Best of luck to all of us!
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Hi. I don't remember my first 'stats' 13 years ago other than IDC stage 2b, lumpectomy , node removal, chemo/rads. Now a new primary, other breast. Just had BM, waiting on path report. Was not recommended to have mastectomy 1st time, but did finally have ovaries out about 3 1/2 years ago. I was 13 years NED.
Regret not having a BMX then, but didn't even consider it. Now I have to do chemo again and probably rads as I have node involvement again. 0 -
I still don't know yet if I am in remission, My cancer: ILC Nottingham grade 3 Ki-67 50% 95% ER positive, 5% Progesterone positive, stage 2b. lumpectomy, and node excision 8 lymph nodes, due to the sentinel node "being loaded with cancer" from my surgeon.. Fristly, My left breast, surgery side, is a full cup size bigger than the right. While it's not overly warm, it does itch (radiation cause?) and lymph area tender, though I have range of motion, and taking aromatase therapy :anastrozole for 5 years maybe longer. Diagnosed on 9/11 of all days, Chemo was done Jan 28th 2019, Radiation done May 1, 2019... due for my Mamo/ultrasound in December, I am going to be 58 years old..
Secondary cancer scares me a Lot!..
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hi,
I guess I am only 1 year and a half late to this post. lol. both my cancers were under 1 cm.
I was having difficulty with tamoxifen, so I had just started taking arimidex.
oh I look forward to being off the arimidex!
only 1.5 years left.
hope you are in good health.
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Hello Friends
I always knew I'd be back here someday ( UGH!)
Im abiut 7 ish yrs out from stage 1 with bilateral LE .Just found ' something' in my mammo yesterday. Same left breast. Biopsy Monday. sigh
Never took rads before ( bad lungs to being with and lost of health issues) and cant take things like arimidex ( Ive broken 6 bones/ osteoporosis)
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Will they do more imaging or a biopsy? Sorry you are facing this scare. Hoping it is benign.
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KBeee Thank you !BIPOSY Monday My husband died 3 years ago ( stage 4 colon for a decade !) I am facing this alone.
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purple32too, Hoping all goes okay with the biopsy. Please keep us posted. Do you have a friend that can go with you? Don't worry about "bothering" people when you need support. Friends WANT to help. Remember that. And your sisters here are always here when you need to vent.
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THX KBeee Biopsy yesterday...results later today. I want to go alone for results . Stomach is already in a knot. TY
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Supporting you from afar!
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The original question was how common is a new cancer in the second breast. This is from the Komen site:
- About 5 percent of women will get a second breast cancer within 8 years of their initial diagnoses [231-232].
- After about 25 years, up to 14 percent of women will have been diagnosed with a second breast cancer [231,235].
Remember, this is looking at risk within a stretch of time, so the longer the time (25 years vs 8,) the higher the risk.There are also stats at this link for DCIS (separate from invasive tumors) and for the affect of other cancers on breast cancer risk.0 -
Here is a really interesting journal article about the incidence of CBC (contralateral breast cancer, or a new primary cancer in the other breast.) The study is done including more than 399,000 patients. It shows that over the whole time of the study,
"Survivors had an overall 5-year cumulative incidence of CBC of 1.49% (95% CI = 1.44%-1.54%),"
And when they separated out more recent cases to account for improved treatments,
" ... [5-year cumulative incidence of CBC] ... decreased over time to 1.31% (95% CI = 1.23%-1.41%) in 2008-2014.
And there was a difference in occurrence depending on type of original tumor.
"For recent diagnoses, the 5-year cumulative incidence of CBC was higher after ER-negative (1.80%, 95% CI = 1.55%-2.07%) and triple negative tumors (1.98%, 95% CI = 1.52%-2.55%), and lowest for women who received hormonal therapy (1.01%, 95% CI = 0.90%-1.13%).
"Conclusions: Although CBC risk is declining in the US from 1992-2015, survivors have approximately twice the risk of an incident breast cancer (in the contralateral breast) compared to the general population. The 5-year cumulative risk of CBC is highest after ER-negative/triple negative tumors highlighting the need for medical surveillance and targeted interventions among these patients."
https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.15_suppl.1549
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Thanks for the links MountainMia!
As a 2x BC (R, then L) person (survivor?) I appreciate all info I can get on statistics!
Jaybird ~
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Jaybird, here's another one for you: it's a Swedish study of 42,600 women. They compared women with contralateral breast cancer (CBC) to unilateral (UBC, only one breast diagnosis.) The results and conclusions in the abstract say:
"Results
An increased risk for CBC was observed among women who had primary breast cancer with ≥ 10 involved lymph nodes compared with node-negative women (adjusted hazard ratio [HR], 1.8; 95% CI, 1.2 to 2.7). The prognosis was poorer in women with CBC than with UBC. The hazard of dying from breast cancer was especially high for women with a short interval time to CBC (adjusted HR, 2.3; 95% CI, 1.8 to 2.8 for CBC diagnosed ≤ 5 years v UBC) and gradually decreased with longer follow-up time but remained higher than the hazard originating from the primary tumor for ≥ 10 years.
ConclusionWomen with advanced-stage primary breast cancer had an increased risk of developing CBC. CBC is associated with an increased risk of dying from breast cancer throughout a long period of follow-up after the primary tumor. Our findings suggest that the event of CBC marks a new clinical situation in terms of investigations for metastases, treatment considerations, and follow-up strategy."
This is sobering. I'm going in for biopsy tomorrow on an ugly mass, description of which implies a second cancer. (Yes, I'll know for sure soon.) My first diagnosis was 2/27/19. Yes, less than a year ago.
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