Risk for Leukemia After Breast Cancer

An ASCO® Poster Brief

Lidia Schapira, MD; Henry G. Kaplan, MD; Judith April Malmgren, PhD


June 24, 2013

The Concern About Secondary Cancer

Editor's Note: How high is the risk for developing acute myeloid leukemia (AML) after a diagnosis of breast cancer?Medscape spoke with Henry G. Kaplan, MD, oncologist at the Swedish Cancer Institute at Swedish Medical Center, and Judith April Malmgren, PhD, Affiliate Assistant Professor, School of Public Health, University of Washington, Seattle, at the 2013 Annual Meeting of the American Society of Clinical Oncology (ASCO®) about their analysis of over 300,000 breast cancer cases and the incidence of leukemia and myelodysplastic syndrome (MDS) after diagnosis of breast cancer.

Medscape: Can you tell me what your study was designed to explore?

Dr. Kaplan: There is a growing concern regarding risk for secondary cancer, and especially leukemia, in breast cancer patients receiving chemotherapy; we have been studying this for quite some time. We took advantage of the opportunity to look at MDS as well as acute leukemia in the Surveillance, Epidemiology, and End Results (SEER) database because MDS has only recently become available as a separate diagnosis. This enables us to broaden our studies from looking only at leukemia to both leukemia and MDS.

We are particularly interested in trying to correlate MDS/AML after breast cancer diagnosis with stage of disease, which is a surrogate for the amount of treatment that the patient has had. We also wanted to look at the age of the patients, because there are well-known data (at least from the radiation literature) that radiation carcinogenesis is age-related.[1,2] We have looked at leukemia after breast cancer treatment in our institutional breast cancer database, and at our institution we have a complete database going back almost 20 years with follow-up for almost every breast cancer patient whom we have ever treated.


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