Should women with breast cancer be screened for lung cancer?
Lung cancer is the most common type of cancer in men and the third most common type of cancer in women. Projections are that 1 in 16 people will be diagnosed with lung cancer in their lifetime - 1 in 15 men, and 1 in 17 women.
Early detection through periodic imaging tests may help detect this dangerous cancer in its early stages, increasing the chances of recovery, but current guidelines for regular checkups are limited to smokers between 50 and 80 years old, although it has been noted that the incidence rate Lung cancer significantly increased in patients with other cancers. In general, and in women with breast cancer in particular, current guidelines do not include cancer in general or breast cancer in particular as a risk factor for lung cancer.
A new study, published in the journal BJS Open, aims to determine the importance of changing guidelines for imaging screening tests for early detection of lung cancer to include women with a history of breast cancer.
Current guidelines for regular lung cancer screening
Adults between 50 and 80 years old.
Those with a smoking history of up to 20 packs who currently smoke or have quit within the past 15 years.
But the guidelines do not include non-smokers or patients with a history of previous malignancies, such as breast cancer
The new study
The researchers — led by Daniela Molina, MD, MD and director of esophageal surgery at Memorial Sloan Kettering Cancer Center in New York — analyzed 2,192 women with first-time lung cancer who underwent a pneumonectomy between December 2017 and January 2000.
The aim of the study in this article, in addition to determining the stage of disease at the time of diagnosis, and the odds of survival, is to determine eligibility for lung cancer screening among women with previously diagnosed breast cancer.
From the results of the study
More than half of the patients in the study 58.4% (1,281 patients) were former smokers.
Only 33.3% of them met the criteria for early detection tests, which means that two-thirds of the sample - although they now had lung cancer - were not included in the early detection tests.
What is worrying about these findings is that about half of lung cancer patients are nonsmokers with no history of smoking, and a proportion of them have breast cancer, which may be a risk factor for lung cancer. As such, the role of imaging for reasons other than smoking becomes particularly important for the early diagnosis of lung cancer, which means that to reduce the diagnosis of cancer at later stages, guidelines for early detection of lung cancer in women may be further evaluated. essential. Approximately 10% of women diagnosed with breast cancer develop a second malignancy within 10 years, in most cases lung cancer.
Also, lung cancer screening guidelines do not include other previous malignancies, such as colorectal cancers, which are among the most common types of cancer in women, as well as breast and lung cancer, which account for nearly 50% of all new cancer diagnoses in women in 2020 Other common cancers may prove in future studies to be risk factors for lung cancer.
Breast cancer and lung cancer
A 2018 analysis published in Frontiers in Oncology found that of the more than 6,000 women diagnosed with lung cancer for the first time after a previous breast cancer, 42 percent were in an advanced stage at the time of diagnosis. Given the low survival rates for lung cancer, which are typically less than 20% for 5 years, it is imperative that the medical community reconsider lung cancer early screening guidelines to include women with a history of breast cancer. .
So far, the relationship between breast cancer and lung cancer is not clearly known, although research indicates the following:
Estrogen is known to play a role in the development of lung cancer by activating the epidermal growth factor receptor (EGFR).
Previous research has shown an increased risk of lung cancer in patients with estrogen receptor-negative, progesterone-receptor-negative, HER2-negative, or triple-negative breast cancer.
Anti-estrogen therapy has been shown to reduce the incidence of lung cancer and has been associated with improved long-term survival in patients with lung cancer after breast cancer.
Study restrictions
However, the authors note a number of limitations to the study, including:
Reliance on one hospital as the only source of data.
The analysis did not take into account the length of time since patients stopped smoking and were diagnosed with lung cancer.
The analysis did not take into account other risk factors, such as radiotherapy, chemotherapy, or anti-estrogen treatments.
