Zwart, L.D.G. (2012) Lange termijn effecten: het ontstaan van tweede tumoren na adjuvante behandeling voor mammacarcinoom : Een retrospectief cohortonderzoek. thesis, Medicine.
Full text available on request.Abstract
Aim: The literature shows that women who are treated for adjuvant breast cancer have an increased risk of developing second primary malignancies. The aim of this research is to access the incidence of second primary malignancies in women in an unselected population who have been treated with adjuvant treatment for a breast neoplasm. This should include how high this incidence is, how soon the second primary malignancies occur, what types of second tumors arose more and whether there is a connection with the receipt of adjuvant radiotherapy, chemotherapy or hormone therapy. Material and Methods: This retrospective cohort study included women with a diagnosis of breast cancer between 1970 and 2006, if they have received curative treatment and if they were younger than 80 years at the time of diagnosis. The data collected from general practices. The study population was divided into groups based on the type of prior adjuvant treatment of breast cancer. Only surgery was taking as the reference group. The groups were compared by independent T-tests, Mann-Whitney tests and Chi-square tests. Incidence density (ID) and Standardized Incidence Ratio (SIR) are compared with data from the Dutch cancer registry. Results: From a population of nearly 94,000 patients, 632 women with breast cancer were included. The average follow-up duration was 13.2 (range 5.2 to 40.0) years. There are 43 local recurrences, 31 contralateral breast cancers and 83 second primary malignancies developed. In total, 157 tumors develop in 134 women (21.2%). The most common second tumors were local recurrences, contralateral breast cancer, malignancies of the skin and malignancies of the colon/rectum. The ID for each tumor type in this study is lower than in the Dutch population. The SIR for each type of tumor is less than one. In the group of women who received only adjuvant radiotherapy has 28.4% of women received a second tumor. This differs significantly with the group of women who have had only surgical treatment. Conclusion: In this unselected population of women treated for breast cancer was not found that after adjuvant treatment for breast cancer with radiotherapy, chemotherapy or a combination of both, an increased risk of developing second malignancies. The most likely explanation is that second malignancies be less registered in the first line. However, in the literature it is well proven. Further research, preferably a prospectively designed study, will reveal which treatments are more at risk of second tumors.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleiders: and Bock Prof. dr. G.H. de in samenwerking met and Berendsen, dr. A.J. and Disciplinegroepen: and Epidemiologie en Huisartsgeneeskunde, Universitair Medisch C |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:01 |
| Last Modified: | 25 Jun 2020 11:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2140 |
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