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Objective <p>Breast cancer is a common second primary malignancy among gastric cancer survivors, yet its biological characteristics and clinical outcomes in this population are not well defined. This study aimed to compare molecular features and survival outcomes between breast cancer developing after gastric cancer and single primary breast cancer, and to clarify whether adverse prognosis is related to tumor biology or patient-related factors.</p> Materials and methods <p>This retrospective population-based study was conducted using the SEER database. Female patients with breast cancer following gastric cancer were compared with those diagnosed with single primary invasive breast cancer. Molecular subtypes, receptor status, clinicopathologic characteristics, and treatment variables were analyzed. Multivariable logistic regression was used to assess associations with molecular features. Overall survival (OS) and breast cancer-specific survival (CSS) were evaluated using Kaplan–Meier analysis and multivariable Cox regression models.</p> Results <p>Among 593,811 included patients, 266 developed breast cancer after gastric cancer. No significant differences were observed between groups in estrogen receptor, progesterone receptor, HER2 status, or molecular subtype distribution. Prior gastric cancer was not independently associated with breast cancer molecular characteristics. Overall survival was significantly worse in patients with a history of gastric cancer (HR, 1.64), whereas breast cancer-specific survival was comparable between groups. Patients with prior gastric cancer were less likely to receive chemotherapy and radiotherapy.</p> Conclusion <p>Breast cancer developing after gastric cancer shows molecular characteristics similar to primary breast cancer. Inferior overall survival appears to be driven by patient-related factors, such as age, comorbidities, and differences in treatment intensity, rather than tumor biology. Preserved CSS indicates comparable responsiveness to standard treatments and underscores the need to avoid unnecessary undertreatment in this patient population.</p>

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Receptor status, molecular subtypes, and survival outcomes of breast cancer following gastric cancer compared with single primary breast cancer

  • 期刊论文

  • 发表日期：

    2026年5月18日

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  • Ahmet Necati Sanli,
  • Bilal Turan,
  • Deniz Esin Tekcan Sanli,
  • Isa Karaca,
  • Fatih Aydogan

摘要

Objective

Breast cancer is a common second primary malignancy among gastric cancer survivors, yet its biological characteristics and clinical outcomes in this population are not well defined. This study aimed to compare molecular features and survival outcomes between breast cancer developing after gastric cancer and single primary breast cancer, and to clarify whether adverse prognosis is related to tumor biology or patient-related factors.

Materials and methods

This retrospective population-based study was conducted using the SEER database. Female patients with breast cancer following gastric cancer were compared with those diagnosed with single primary invasive breast cancer. Molecular subtypes, receptor status, clinicopathologic characteristics, and treatment variables were analyzed. Multivariable logistic regression was used to assess associations with molecular features. Overall survival (OS) and breast cancer-specific survival (CSS) were evaluated using Kaplan–Meier analysis and multivariable Cox regression models.

Results

Among 593,811 included patients, 266 developed breast cancer after gastric cancer. No significant differences were observed between groups in estrogen receptor, progesterone receptor, HER2 status, or molecular subtype distribution. Prior gastric cancer was not independently associated with breast cancer molecular characteristics. Overall survival was significantly worse in patients with a history of gastric cancer (HR, 1.64), whereas breast cancer-specific survival was comparable between groups. Patients with prior gastric cancer were less likely to receive chemotherapy and radiotherapy.

Conclusion

Breast cancer developing after gastric cancer shows molecular characteristics similar to primary breast cancer. Inferior overall survival appears to be driven by patient-related factors, such as age, comorbidities, and differences in treatment intensity, rather than tumor biology. Preserved CSS indicates comparable responsiveness to standard treatments and underscores the need to avoid unnecessary undertreatment in this patient population.