Renal transplantation is known to be associated with increased risk of malignancy. Concurrent presence of malignant diseases and transplantation may influence overall survival. This study summarizes our 35-year experience in breast cancer (BC) in renal transplant patients focusing on the incidence of BC and its impact on survival of this population.
Prospectively collected data of female patients treated with renal transplantation for chronic renal failure from 1973 to 2017 were analysed. Patients diagnosed with BC were identified. Age at transplantation, age at BC diagnosis, date and causes of death were recorded for all patients. BC incidence and overall survival were calculated. Kaplan-Meier and Cox proportional hazards models were used to determine the difference in survival and hazard between the two patient groups.
Out of 821 transplant patients, 7 developed BC. The mean age in the total population of kidney transplant patients was 42.7 years (SD = 13.8), while the mean age of women diagnosed with BC was 48.3 years (SD = 10.2) and 53.0 years (SD = 12.3), at transplantation and BC diagnosis respectively. In total 7 women (1.0%) were diagnosed with BC of which 4 died from BC and 1 from a different cause. The median survival for women diagnosed with BC was 193 months (16.1 years) compared to 299 months (24.9 years) from transplantation for women not diagnosed with BC (p < 0.001). The transplanted women with BC have 4.3 times higher hazard of dying (p = 0.002) compared to those without. After adjusting for age, this difference decreases to 2.4 (p = 0.059). The median overall survival of the BC transplant patients was 35 months from cancer diagnosis. Regarding the incidence of BC in the total sample, there are approximately 13 new cases per 100,000 person-months. In the age groups ≤ 45, 46-60 and ≥61 years 2, 23 and 18 new BC cases per 100,000 person-months were recorded.
BC incidence appears increased in this population. BC diagnosis may adversely affect survival of renal transplant recipients. Further study of predisposing BC risk factors may reveal additional associations.
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All authors have declared no conflicts of interest.