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Tumor Progression02:07

Tumor Progression

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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
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Nonmetastatic breast cancer patients subsequently developing second primary malignancy: A population-based study.

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  • 1Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

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Area of Science:

  • Oncology
  • Cancer Epidemiology
  • Biostatistics

Background:

  • Increasing life spans lead to higher risks of second primary cancers (SPCs) in breast cancer (BC) survivors.
  • Limited data exists on multiple primary cancer (MPC) patients with nonmetastatic breast cancer as a first primary malignancy (BCFPM).

Purpose of the Study:

  • To analyze prognostic factors for breast cancer-specific survival (BCSS) in BCFPM patients.
  • To develop and validate a predictive nomogram for BCSS in BCFPM patients.

Main Methods:

  • Retrospective analysis of 8616 BCFPM patients from the SEER database (2010-2015).
  • Stepwise regression and competing risk models used to identify prognostic factors.
  • Development and validation of a prognostic nomogram using training and validation cohorts.

Main Results:

  • The most common SPCs were female BC and lung cancer, with a median latency of 22 months.
  • Subtypes, grade, T/N classification, radiation, and SPC site were independent prognostic factors for BCSS.
  • The nomogram demonstrated high accuracy in predicting 3- and 5-year BCSS (C-indices 0.715 and 0.683).

Conclusions:

  • BC survivors have a significant risk of SPC and reduced survival.
  • A validated nomogram can predict BCSS in BCFPM patients, facilitating individualized follow-up and potentially prolonging survival.