Acute myeloid leukemia after breast cancer: a population-based comparison with hematological malignancies and other cancers

Clinical trials frequently report acute myeloid leukemia (AML) as a complication of adjuvant chemotherapy for breast cancer (BC).Patients and methods: This retrospective population-based study investigated AML risk after a prior BC diagnosis and compared the results with women after a prior diagnosis of hematological malignancies (HM), other cancers combined (OCC), and the age-matched Australian female population.Results: Women with a prior BC diagnosis had 2.56 times the risk of developing AML compared with the Australian female population (P <0.001). AML risk was also elevated after prior HM and OCC diagnoses (4.73, P <0.001, and 1.70, P <0.001, respectively). Although the incidence of AML rose sharply with age in all cohorts, the age-specific relative risk was highest in the 30- to 49-age-group and decreased with increasing age. AML risk increased with the duration of follow-up but there was no change of risk during the 23 years of this study.Conclusion: AML risk was elevated after a prior diagnosis of BC but there was no evidence of an increasing risk of AML after a BC diagnosis or, in any of the other cancer cohorts, during this era of expansion of the evidence base for more intensive treatments.