Prognostic Characteristics of Operated Breast Cancer Patients with Second Primary Lung Cancer: A Retrospective Study

Figures & data

Table 1 Breast Cancer Related Clinicopathological Characteristics

Parameters	n (%)
Age at the diagnosis of breast cancer (years)	49.5 (28–81)
<40	17 (12.4)
40–49	51 (37.2)
50–59	47 (34.3)
60–69	16 (11.7)
≥70	6 (4.4)
Family history of malignancies
With	30 (24.0)
Without	95 (76.0)
Menstrual status at the diagnosis of breast cancer
Menopause	71 (52.6)
Premenopause	64 (47.4)
Location of breast cancer
Left	60 (50.4)
Right	59 (49.6)
pT stage of breast cancer
T1	55 (78.6)
T2-4	15 (21.4)
pN stage of breast cancer
N0	31 (70.5)
N1-3	13 (29.5)
pM stage of breast cancer
M0	134 (98.5)
M1	2 (1.5)
pTNM stage of breast cancer
I/II	34 (81.0)
III/IV	8 (19.0)
Expression status of ER
Positive	35 (76.1)
Negative	11 (23.9)
Expression status of PR
Positive	30 (65.2)
Negative	16 (34.8)
Expression status of HER-2
Positive	11 (23.9)
Negative	35 (76.1)
Chemotherapy
With	92 (67.6)
Without	44 (32.4)
Radiotherapy
With	55 (40.4)
Without	81 (59.6)
Median interval between the diagnoses of breast cancer and lung cancer	60 (2–456)
Simultaneous (<6 months)	7 (5.1)
Metachronous (≥6 months)	130 (94.9)

Abbreviations: ER, estrogen receptor; PR, progesterone receptor; HER-2, human epidermal growth factor receptor-2.

Table 2 Lung Cancer Related Clinicopathological and Prognostic Characteristics

Parameters	n (%)
Median age at the diagnosis of lung cancer (years)	58 (31–84)
<40	6 (4.4)
40–49	25 (18.2)
50–59	42 (30.7)
60–69	43 (31.4)
≥70	21 (15.3)
Smoking
With	1 (0.7)
Without	136 (99.3)
Comorbidity
Hypertension	19 (13.9)
Diabetes	12 (8.8)
Location of lung cancer
Left	56 (40.9)
Right	73 (53.3)
Bilateral	8 (5.8)
Relative position of breast and lung cancer
Ipsilateral	64 (53.8)
Contralateral	55 (46.2)
Pathological subtype of lung cancer
Adenocarcinoma	123 (89.8)
Squamous cell carcinoma	6 (4.4)
Small cell carcinoma	2 (1.4)
Adenosquamous carcinoma	3 (2.2)
Others	3 (2.2)
Differentiation of lung cancer
Poor	35 (27.1)
Moderate	81 (62.8)
Well	13 (10.1)
pT stage of lung cancer
T1/2	108 (87.1)
T3/4	16 (12.9)
pN stage of lung cancer
N0	90 (73.8)
N1/2/3	32 (26.2)
pM stage of lung cancer
M0	102 (80.3)
M1	25 (19.7)
pTNM stage of lung cancer
I/II	95 (73.1)
III/IV	35 (26.9)
Surgical therapy
With	103 (79.2)
Without	27 (20.8)
Chemotherapy
With	22 (16.9)
Without	108 (83.1)
Radiotherapy
With	3 (2.3)
Without	127 (97.7)
Targeted therapy
With	16 (12.3)
Without	114 (87.7)
Existentiality
Alive	94 (79.0)
Dead	25 (21.0)
Median follow-up time (months)	20 (1–107)

Table 3 Results of Univariate and Multivariate Cox Regression

Parameters	Univariate			Multivariate
	HR	95% CI	P value	HR	95% CI	P value
Age≥50 (breast)	1.288	0.568–2.921	0.544
Menopause	1.224	0.542–2.763	0.625
Family history of malignancies	1.188	0.472–2.989	0.714
pT2-4 of breast cancer	0.412	0.052–3.256	0.400
pN1-3 of breast cancer	1.780	0.108–29.285	0.687
pTNM III/IV of breast cancer	1.992	0.492–8.074	0.334
Positive PR	1.154	0.104–12.757	0.907
Positive HER-2	0.258	0.022–2.986	0.278
Chemotherapy for breast cancer	0.680	0.305–1.515	0.345
Radiotherapy for breast cancer	2.340	1.060–5.166	0.035	1.795	0.782–4.120	0.168
Interval (<5 years)	0.665	0.293–1.508	0.329
Age≥50 (lung)	1.697	0.581–4.953	0.333
Location of lung cancer	1.281	0.665–2.468	0.459
Pathological subtype of lung cancer (adenocarcinoma)	0.560	0.210–1.497	0.248
Poor differentiation of lung cancer	9.276	3.699–23.265	<0.001	6.372	2.441–16.633	<0.001
pT3/4 of lung cancer	1.657	0.986–2.785	0.056
pN1-3 of lung cancer	27.488	6.342–119.144	<0.001
pM1 of lung cancer	6.883	2.769–17.110	<0.001
pTNM III/IV of lung cancer	7.211	3.006–17.299	<0.001	5.830	2.295–14.813	<0.001

Abbreviations: PR, progesterone receptor; HER-2, human epidermal growth factor receptor-2.

Figure 1 Kaplan–Meier survival curve showing the relationship between the differentiation status of lung cancer and overall survival.

Figure 2 Kaplan–Meier survival curve showing the relationship between the pTNM stage of lung cancer and overall survival.

Table 4 Comparison of Clinicopathological and Prognostic Characteristics Between Lung Cancer Patients with and without Breast Cancer

Parameters	Before PSM			After PSM			Standard Percentage Bias
	With Breast Cancer (n=119)	Without Breast Cancer (n=473)	P value	With Breast Cancer (n=118)	Without Breast Cancer (n=118)	P value	Before	After
Age, mean (SD)	57.8±11.2	58.1±10.7	0.786	57.8±11.2	56.2±10.8	0.254	−2.8	15.0
Hypertension, n (%)			0.448			0.552	−8.0	7.1
With	16 (13.4)	77 (16.3)		16 (13.6)	13 (11.0)
Without	103 (86.6)	396 (83.7)		102 (86.4)	105 (89.0)
Diabetes, n (%)			0.079			0.801	16.2	3.7
With	9 (7.6)	18 (3.8)		9 (7.6)	8 (6.8)
Without	110 (92.4)	455 (96.2)		109 (92.4)	110 (93.2)
pTNM stage, n (%)			<0.001			0.223	31.1	2.4
I	83 (69.8)	361 (76.3)		83 (70.3)	80 (67.8)
II	5 (4.2)	43 (9.1)		5 (4.2)	7 (5.9)
III	8 (6.7)	47 (9.9)		8 (6.8)	16 (13.5)
IV	23 (19.3)	22 (4.7)		22 (18.7)	15 (12.7)
Differentiation of, n (%)			0.039			0.908	−16.3	4.1
Poor	33 (27.7)	127 (26.9)		33 (28.0)	36 (30.5)
Moderate	75 (63.0)	257 (54.3)		74 (62.7)	71 (60.2)
Well	11 (9.3)	89 (18.8)		11 (9.3)	11 (9.3)
Pathological type, n (%)			0.374			0.881	17.9	−4.8
Adenocarcinoma	106 (89.1)	440 (93.0)		106 (89.9)	105 (89.0)
Squamous cell	5 (4.2)	19 (4.0)		5 (4.2)	4 (3.4)
Small cell carcinoma	2 (1.7)	5 (1.1)		2 (1.7)	4 (3.4)
Adenosquamous carcinoma	3 (2.5)	5 (1.1)		3 (2.5)	2 (1.7)
Others	3 (2.5)	4 (0.8)		2 (1.7)	3 (2.5)
Existentiality, n (%)			0.003			0.173	–	–
Alive	94 (79.0)	422 (89.2)		93 (78.8)	101 (85.6)
Dead	25 (21.0)	51 (10.8)		25 (21.2)	17 (14.4)

Abbreviations: SD, standard deviation; PSM, propensity score match.

Figure 3 The comparison of overall survival between lung cancer patients with and without breast cancer before the propensity score match.

Figure 4 The comparison of overall survival between lung cancer patients with and without breast cancer after the propensity score match.