MedicalResearch.com Interview with:
Dr. Marie Joelle Jabagi, PharmD, MPH
University of Paris Sud, Paris-Saclay University, Paris
Health Product Epidemiology Department
French National Agency for Medicines and Health Products Safety
MedicalResearch.com: What is the background for this study?
Response: Secondary hematologic malignant neoplasms that develop months or years after the diagnosis of breast cancer may be a consequence of genetic predisposition, environmental factors, previous cancer treatments or a combination of all those factors. These secondary malignant neoplasms are increasingly becoming a concern given that the population of breast cancer survivors is growing substantially. However, their frequency in real life has been poorly investigated to date.
The aims of our research were to estimate the frequency of various types of hematologic malignant neoplasm following a diagnosis of primary breast cancer among women aged 20 to 85 years in France during the past decade, and to compare it to the corresponding frequency in women of the French general population.
MedicalResearch.com: What are the main findings?
Response: Among the 439 704 women diagnosed with a primary breast cancer in France between July 1, 2006 and December 31, 2015, 3,046 cases of hematologic malignant neoplasm occurred within a median follow-up time of 5 years after breast cancer diagnosis. Compared with women of the French general population, breast cancer survivors were nearly 3 times more likely to develop acute myeloid leukemia (AML), 5 times more likely to develop Myelodysplastic syndrome (MDS) and twice more likely to develop acute lymphoblastic leukemia or lymphocytic lymphoma (ALL/LL). A slight increase in the incidence of multiple myeloma (MM) was also noted.
MedicalResearch.com: What should readers take away from your report?
Response: These findings suggest that, in the recent area, AML and MDS occur more frequently among breast cancer survivors than among women in the general population. Other hematologic malignant neoplasm types such as ALL/LL and MM may also be a concern for breast cancer survivors. These findings serve to better inform practicing oncologists, and breast cancer survivors should be advised of the increased risk of developing certain hematologic malignant neoplasms after their first cancer diagnosis.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: The recent discovery of the gene signatures that guide treatment decisions in early-stage breast cancer might reduce the number of patients exposed to cytotoxic chemotherapy and its complications, including hematologic malignant neoplasm. Therefore, continuing to monitor hematologic malignant neoplasm trends is necessary, especially given that approaches to cancer treatment are rapidly evolving. Further research is also required to assess the modality of treatment for and the genetic predisposition to these secondary malignant neoplasms.
Jabagi MJ, Vey N, Goncalves A, Le Tri T, Zureik M, Dray-Spira R. Evaluation of the Incidence of Hematologic Malignant Neoplasms Among Breast Cancer Survivors in France. JAMA Netw Open. 2019;2(1):e187147. doi:10.1001/jamanetworkopen.2018.7147
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