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Title: Dose to the Contralateral Breast From Radiotherapy and Risk of Second Primary Breast Cancer in the WECARE Study

Abstract

Purpose: To quantify the risk of second primary breast cancer in the contralateral breast (CB) after radiotherapy (RT) for first breast cancer. Methods and Materials: The study population included participants in the Women's Environmental, Cancer, and Radiation Epidemiology study: 708 cases (women with asynchronous bilateral breast cancer) and 1399 controls (women with unilateral breast cancer) counter-matched on radiation treatment. Participants were <55 years of age at first breast cancer. Absorbed doses to quadrants of the CB were estimated. Rate ratios (RR) and 95% confidence intervals (CI) were calculated using multivariable-adjusted conditional logistic regression models. Results: Across all patients, the mean radiation dose to the specific quadrant of the CB tumor was 1.1 Gy. Women <40 years of age who received >1.0 Gy of absorbed dose to the specific quadrant of the CB had a 2.5-fold greater risk for CB cancer than unexposed women (RR = 2.5, 95% CI 1.4-4.5). No excess risk was observed in women >40 years of age. Women <40 years of age with follow-up periods >5 years had a RR of 3.0 (95% CI 1.1-8.1), and the dose response was significant (excess RR per Gy of 1.0, 95% CI 0.1-3.0). Conclusions: Women <40 years of age whomore » received a radiation dose >1.0 Gy to the CB had an elevated, long-term risk of developing a second primary CB cancer. The risk is inversely related to age at exposure and is dose dependent.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [6];  [7];  [8];  [9];  [10];  [11];  [12];  [13];  [3];  [14];  [15]
  1. Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States), E-mail: mstovall@mdanderson.org
  2. Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  3. Department of Preventive Medicine, University of Southern California, Los Angeles, CA (United States)
  4. International Epidemiology Institute, Rockville, MD (United States)
  5. (United States)
  6. Radiation Effects Research Foundation (RERF), Hiroshima (Japan)
  7. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen (Denmark)
  8. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  9. Department of Statistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  10. Department of Cancer Etiology, City of Hope National Medical Center, Duarte, CA (United States)
  11. Department of Epidemiology, University of Iowa, Iowa City, IA (United States)
  12. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (United States)
  13. Department of Epidemiology, University of California, Irvine, CA (United States)
  14. Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States)
  15. (United States) (and others)
Publication Date:
OSTI Identifier:
21172452
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 72; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2008.02.040; PII: S0360-3016(08)00348-9; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; EPIDEMIOLOGY; MAMMARY GLANDS; PATIENTS; RADIATION DOSES; RADIATION HAZARDS; RADIOTHERAPY; WOMEN

Citation Formats

Stovall, Marilyn, Smith, Susan A., Langholz, Bryan M., Boice, John D., Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, Shore, Roy E., Andersson, Michael, Buchholz, Thomas A., Capanu, Marinela, Bernstein, Leslie, Lynch, Charles F., Malone, Kathleen E., Anton-Culver, Hoda, Haile, Robert W., Rosenstein, Barry S., and Department of Radiation Oncology, New York School of Medicine, New York, NY. Dose to the Contralateral Breast From Radiotherapy and Risk of Second Primary Breast Cancer in the WECARE Study. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2008.02.040.
Stovall, Marilyn, Smith, Susan A., Langholz, Bryan M., Boice, John D., Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, Shore, Roy E., Andersson, Michael, Buchholz, Thomas A., Capanu, Marinela, Bernstein, Leslie, Lynch, Charles F., Malone, Kathleen E., Anton-Culver, Hoda, Haile, Robert W., Rosenstein, Barry S., & Department of Radiation Oncology, New York School of Medicine, New York, NY. Dose to the Contralateral Breast From Radiotherapy and Risk of Second Primary Breast Cancer in the WECARE Study. United States. doi:10.1016/j.ijrobp.2008.02.040.
Stovall, Marilyn, Smith, Susan A., Langholz, Bryan M., Boice, John D., Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, Shore, Roy E., Andersson, Michael, Buchholz, Thomas A., Capanu, Marinela, Bernstein, Leslie, Lynch, Charles F., Malone, Kathleen E., Anton-Culver, Hoda, Haile, Robert W., Rosenstein, Barry S., and Department of Radiation Oncology, New York School of Medicine, New York, NY. Sat . "Dose to the Contralateral Breast From Radiotherapy and Risk of Second Primary Breast Cancer in the WECARE Study". United States. doi:10.1016/j.ijrobp.2008.02.040.
@article{osti_21172452,
title = {Dose to the Contralateral Breast From Radiotherapy and Risk of Second Primary Breast Cancer in the WECARE Study},
author = {Stovall, Marilyn and Smith, Susan A. and Langholz, Bryan M. and Boice, John D. and Department of Medicine, Vanderbilt University Medical Center, Nashville, TN and Shore, Roy E. and Andersson, Michael and Buchholz, Thomas A. and Capanu, Marinela and Bernstein, Leslie and Lynch, Charles F. and Malone, Kathleen E. and Anton-Culver, Hoda and Haile, Robert W. and Rosenstein, Barry S. and Department of Radiation Oncology, New York School of Medicine, New York, NY},
abstractNote = {Purpose: To quantify the risk of second primary breast cancer in the contralateral breast (CB) after radiotherapy (RT) for first breast cancer. Methods and Materials: The study population included participants in the Women's Environmental, Cancer, and Radiation Epidemiology study: 708 cases (women with asynchronous bilateral breast cancer) and 1399 controls (women with unilateral breast cancer) counter-matched on radiation treatment. Participants were <55 years of age at first breast cancer. Absorbed doses to quadrants of the CB were estimated. Rate ratios (RR) and 95% confidence intervals (CI) were calculated using multivariable-adjusted conditional logistic regression models. Results: Across all patients, the mean radiation dose to the specific quadrant of the CB tumor was 1.1 Gy. Women <40 years of age who received >1.0 Gy of absorbed dose to the specific quadrant of the CB had a 2.5-fold greater risk for CB cancer than unexposed women (RR = 2.5, 95% CI 1.4-4.5). No excess risk was observed in women >40 years of age. Women <40 years of age with follow-up periods >5 years had a RR of 3.0 (95% CI 1.1-8.1), and the dose response was significant (excess RR per Gy of 1.0, 95% CI 0.1-3.0). Conclusions: Women <40 years of age who received a radiation dose >1.0 Gy to the CB had an elevated, long-term risk of developing a second primary CB cancer. The risk is inversely related to age at exposure and is dose dependent.},
doi = {10.1016/j.ijrobp.2008.02.040},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 72,
place = {United States},
year = {2008},
month = {11}
}