Malignant Breast Tumors After Radiotherapy for a First Cancer During Childhood
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Published:2005-01-01
Issue:1
Volume:23
Page:197-204
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ISSN:0732-183X
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Container-title:Journal of Clinical Oncology
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language:en
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Short-container-title:JCO
Author:
Guibout Catherine1, Adjadj Elisabeth1, Rubino Carole1, Shamsaldin Akthar1, Grimaud Emmanuel1, Hawkins Mike1, Mathieu Marie-Christine1, Oberlin Odile1, Zucker Jean-Michel1, Panis Xavier1, Lagrange Jean-Léon1, Daly-Schveitzer Nicolas1, Chavaudra Jean1, de Vathaire Florent1
Affiliation:
1. From the National Institute of Health and Medical Research, Cancer Epidemiology Research Unit (U605 INSERM), Physics Department, Department of Paediatrics, and Department of Pathology, Institut Gustave Roussy, Villejuif; Department of Paediatrics, Institut Curie, Paris; Department of Radiotherapy, Institut Jean Godinot, Reims; Department of Radiotherapy, Centre Lacassagne, Nice; Department of Radiotherapy, Centre Claudius-Regaud, Toulouse, France; and Childhood Cancer Research Group, Radcliffe Infirmary,...
Abstract
Purpose To assess the specific role of treatment and type of first cancer (FC) in the risk of long-term subsequent breast cancer (BC) among childhood cancer survivors. Patients and Methods In a cohort of 1,814 3-year female survivors treated between 1946 and 1986 in eight French and English centers, data on chemotherapy and radiotherapy were collected. Individual estimation of radiation dose to each breast was performed for the 1,258 patients treated by external radiotherapy; mean dose to breast was 5.06 Gy (range, 0.0 to 88.0 Gy) delivered in 20 fractions (mean). Results Mean follow-up was 16 years; 16 patients developed a clinical BC, 13 after radiotherapy. The cumulative incidence of BC was 2.8% (95% CI, 1.0% to 4.5%) 30 years after the FC and 5.1% (95% CI, 2.1% to 8.2%) at the age of 40 years. The annual excess incidence increased as age increased, whereas the standardized incidence ratio decreased. On average, each Gray unit received by any breast increased the excess relative risk of BC by 0.13 (< 0.0 to 0.75). After stratification on castration and attained age, and adjusting for radiation dose, FC type, and chemotherapy, a higher risk of a subsequent BC was associated with Hodgkin’s disease (relative risk, 7.0; 95% CI, 1.4 to 30.9). Conclusion The reported high risk of BC after childhood Hodgkin’s disease treatment seems to be due not only to a higher radiation dose to the breasts, but also to a specific susceptibility.
Publisher
American Society of Clinical Oncology (ASCO)
Subject
Cancer Research,Oncology
Reference47 articles.
1. United Nations: United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) Ionising Radiation: Sources and Biological Effects. 1994. Report to the General Assembly, with annexes . New York, NY, United Nations Sales Publications, 1994 2. Effets tardifs de la radiothérapie chez l'enfant 3. Hodgkin's disease in the very young 4. Tucker MA, Meadows AT, Boice JD, et al: Cancer risk following treatment of childhood cancer, in Boice JD, Fraumeni JF (eds): Radiation Carcinogenesis Epidemiology . New York, NY, Raven Press, pp 211,1984-224 5. Second malignant neoplasms in children: an update from the Late Effects Study Group.
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