We obtained female breast cancer case and population data using the SEER 13 Registries Database excluding the Alaska Native Tumor Registry (November 2018 submission, 1992–2016) [13]. We used the SEER 13 Registries Database because it includes the time periods when there were major advances in breast cancer treatment and provides long-term follow-up to examine trends in CBC risk. We identified women aged 30 to 84 years who were diagnosed with a first primary unilateral invasive breast cancer with known laterality and who survived ≥ 1 year without developing a second cancer. We excluded women aged < 30 years given the relatively low number of breast cancers diagnosed prior to this age and women aged ≥ 85 years due to under-reporting of second cancers among older patients [14]. Those diagnosed with a first breast cancer at stage IV or based on autopsy reports/death certificates only were not included. The analytic cohort included 419,818 women with invasive unilateral breast cancer who survived for ≥ 1 year and who were diagnosed between 1992 and 2015 and followed through 2016.

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