title: Characteristics and survival of patients with metachronous or synchronous double primary malignancies: breast and thyroid cancer.
abstract: BACKGROUND
  Clinical experiences suggest that breast cancer (BC) and thyroid cancer (TC) occur metachronously or synchronously in a patient more frequently than it would by chance. This study was conducted to investigate the clinicopathological characteristics and survival of these double primary malignancies.
  
  
  METHODS
  18732 patients with first primary BC and 12877 female patients with first primary TC were performed in this retrospective case-controlled study. The control groups were matched with both age at diagnosis and time of surgery (±2 years). The clinicopathological factors, Overall survival (OS), and HRs were evaluated by SPSS.
  
  
  RESULTS
  There were 91(0.49%) BC patients developed metachronous second primary TC (B-T group), and 117 (0.91%) TC patients developed metachronous second primary BC (T-B group).The expression of estrogen and progesterone receptors, and the value of Ki-67, were significantly higher in the B-T group than control. The median value of thyroid globulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) were higher in T-B group than control (p <0.05). The duration before second primary cancer was shorter for the B-T group than the T-B group (4.09 years vs. 5.82 years, p<0.001). B-T group patients showed poorer survival than BC only patients (p=0.044).
  
  
  CONCLUSIONS
  In general, the overall risk of the occurrence of a second primary TC or BC elevated highly in patients with BC or TC. Detailed mechanisms need to be studied to explore the association between these two cancers. Early detection and effective prevention for the first primary BC or TC patients are necessities for reducing the incidence of the second primary cancer and improving the OS.
authors.affiliation: Department of Breast Oncology, Key Laboratory of Breast Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R.China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Maxillofacial and Otorhinolaryngology Head and Neck Surgery, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R. China.
authors.forename: Yansheng
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Breast Cancer Pathology and Research Laboratory, Key Laboratory of Breast Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R. China.
authors.forename: Fangfang
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Breast Cancer Pathology and Research Laboratory, Key Laboratory of Breast Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R. China.
authors.forename: Li
authors.initials: L
authors.lastname: Fu
authors.affiliation: Department of Breast Oncology, Key Laboratory of Breast Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R.China.
authors.forename: Zhongsheng
authors.initials: Z
authors.lastname: Tong
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology*; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology*
keywords: breast cancer; clinicopathologic characteristics; double primary malignancies; prognosis; thyroid cancer