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Title: Reproductive Status at First Diagnosis Influences Risk of Radiation-Induced Second Primary Contralateral Breast Cancer in the WECARE Study

Abstract

Purpose: Our study examined whether reproductive and hormonal factors before, at the time of, or after radiation treatment for a first primary breast cancer modify the risk of radiation-induced second primary breast cancer. Methods and Materials: The Women's Environmental, Cancer and Radiation Epidemiology (WECARE) Study is a multicenter, population-based study of 708 women (cases) with asynchronous contralateral breast cancer (CBC) and 1399 women (controls) with unilateral breast cancer. Radiotherapy (RT) records, coupled with anthropomorphic phantom simulations, were used to estimate quadrant-specific radiation dose to the contralateral breast for each patient. Rate ratios (RR) and 95% confidence intervals (CI) were computed to assess the relationship between reproductive factors and risk of CBC. Results: Women who were nulliparous at diagnosis and exposed to {>=}1 Gy to the contralateral breast had a greater risk for CBC than did matched unexposed nulliparous women (RR = 2.2; 95% CI, 1.2-4.0). No increased risk was seen in RT-exposed parous women (RR = 1.1; 95% CI, 0.8-1.4). Women treated with RT who later became pregnant (8 cases and 9 controls) had a greater risk for CBC (RR = 6.0; 95% CI, 1.3-28.4) than unexposed women (4 cases and 7 controls) who also became pregnant. The association ofmore » radiation with risk of CBC did not vary by number of pregnancies, history of breastfeeding, or menopausal status at the time of first breast cancer diagnosis. Conclusion: Nulliparous women treated with RT were at an increased risk for CBC. Although based on small numbers, women who become pregnant after first diagnosis also seem to be at an increased risk for radiation-induced CBC.« less

Authors:
 [1];  [2];  [3];  [1];  [4];  [5];  [6];  [7];  [8]; ;  [9];  [3]; ;  [1];  [10];  [11]
  1. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  2. International Epidemiology Institute, Rockville, MD and Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, TN (United States)
  3. Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX (United States)
  4. Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA (United States)
  5. Cancer Prevention Institute of California, Fremont, CA, and Stanford University School of Medicine and Stanford Cancer Institute, Stanford, CA (United States)
  6. Department of Epidemiology, University of Iowa, Iowa City, IA (United States)
  7. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen (Denmark)
  8. Dalla Lana School of Public Health, University of Toronto and Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario (Canada)
  9. Department of Preventive Medicine, University of Southern California, Los Angeles, CA (United States)
  10. Department of Environmental Medicine, New York University, New York, NY (United States)
  11. (Japan)
Publication Date:
OSTI Identifier:
22149624
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 4; Other Information: Copyright (c) 2012 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; DIAGNOSIS; EPIDEMIOLOGY; HEALTH HAZARDS; HORMONES; MAMMARY GLANDS; NEOPLASMS; PATIENTS; PHANTOMS; PREGNANCY; RADIATION DOSES; RADIOTHERAPY; SIMULATION; WOMEN

Citation Formats

Brooks, Jennifer D., E-mail: brooksj@mskcc.org, Boice, John D., Stovall, Marilyn, Reiner, Anne S., Bernstein, Leslie, John, Esther M., Lynch, Charles F., Mellemkjaer, Lene, Knight, Julia A., Thomas, Duncan C., Haile, Robert W., Smith, Susan A., Capanu, Marinela, Bernstein, Jonine L., Shore, Roy E., and Radiation Effects Research Foundation, Hiroshima. Reproductive Status at First Diagnosis Influences Risk of Radiation-Induced Second Primary Contralateral Breast Cancer in the WECARE Study. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.01.047.
Brooks, Jennifer D., E-mail: brooksj@mskcc.org, Boice, John D., Stovall, Marilyn, Reiner, Anne S., Bernstein, Leslie, John, Esther M., Lynch, Charles F., Mellemkjaer, Lene, Knight, Julia A., Thomas, Duncan C., Haile, Robert W., Smith, Susan A., Capanu, Marinela, Bernstein, Jonine L., Shore, Roy E., & Radiation Effects Research Foundation, Hiroshima. Reproductive Status at First Diagnosis Influences Risk of Radiation-Induced Second Primary Contralateral Breast Cancer in the WECARE Study. United States. doi:10.1016/J.IJROBP.2012.01.047.
Brooks, Jennifer D., E-mail: brooksj@mskcc.org, Boice, John D., Stovall, Marilyn, Reiner, Anne S., Bernstein, Leslie, John, Esther M., Lynch, Charles F., Mellemkjaer, Lene, Knight, Julia A., Thomas, Duncan C., Haile, Robert W., Smith, Susan A., Capanu, Marinela, Bernstein, Jonine L., Shore, Roy E., and Radiation Effects Research Foundation, Hiroshima. Thu . "Reproductive Status at First Diagnosis Influences Risk of Radiation-Induced Second Primary Contralateral Breast Cancer in the WECARE Study". United States. doi:10.1016/J.IJROBP.2012.01.047.
@article{osti_22149624,
title = {Reproductive Status at First Diagnosis Influences Risk of Radiation-Induced Second Primary Contralateral Breast Cancer in the WECARE Study},
author = {Brooks, Jennifer D., E-mail: brooksj@mskcc.org and Boice, John D. and Stovall, Marilyn and Reiner, Anne S. and Bernstein, Leslie and John, Esther M. and Lynch, Charles F. and Mellemkjaer, Lene and Knight, Julia A. and Thomas, Duncan C. and Haile, Robert W. and Smith, Susan A. and Capanu, Marinela and Bernstein, Jonine L. and Shore, Roy E. and Radiation Effects Research Foundation, Hiroshima},
abstractNote = {Purpose: Our study examined whether reproductive and hormonal factors before, at the time of, or after radiation treatment for a first primary breast cancer modify the risk of radiation-induced second primary breast cancer. Methods and Materials: The Women's Environmental, Cancer and Radiation Epidemiology (WECARE) Study is a multicenter, population-based study of 708 women (cases) with asynchronous contralateral breast cancer (CBC) and 1399 women (controls) with unilateral breast cancer. Radiotherapy (RT) records, coupled with anthropomorphic phantom simulations, were used to estimate quadrant-specific radiation dose to the contralateral breast for each patient. Rate ratios (RR) and 95% confidence intervals (CI) were computed to assess the relationship between reproductive factors and risk of CBC. Results: Women who were nulliparous at diagnosis and exposed to {>=}1 Gy to the contralateral breast had a greater risk for CBC than did matched unexposed nulliparous women (RR = 2.2; 95% CI, 1.2-4.0). No increased risk was seen in RT-exposed parous women (RR = 1.1; 95% CI, 0.8-1.4). Women treated with RT who later became pregnant (8 cases and 9 controls) had a greater risk for CBC (RR = 6.0; 95% CI, 1.3-28.4) than unexposed women (4 cases and 7 controls) who also became pregnant. The association of radiation with risk of CBC did not vary by number of pregnancies, history of breastfeeding, or menopausal status at the time of first breast cancer diagnosis. Conclusion: Nulliparous women treated with RT were at an increased risk for CBC. Although based on small numbers, women who become pregnant after first diagnosis also seem to be at an increased risk for radiation-induced CBC.},
doi = {10.1016/J.IJROBP.2012.01.047},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}