Mortality from breast cancer after irradiation during fluoroscopic examinations in patients being treated for tuberculosis

Journal Article · Thu Nov 09 00:00:00 EST 1989 · New England Journal of Medicine; (USA)

DOI:https://doi.org/10.1056/NEJM198911093211902· OSTI ID:5155710

Miller, A B; Howe, G R; Sherman, G J; Lindsay, J P; Yaffe, M J; Dinner, P J; Risch, H A; Preston, D L ^[1]

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1. National Cancer Institute of Canada Epidemiology Unit, Toronto (Canada)

The increasing use of mammography to screen asymptomatic women makes it important to know the risk of breast cancer associated with exposure to low levels of ionizing radiation. We examined the mortality from breast cancer in a cohort of 31,710 women who had been treated for tuberculosis at Canadian sanatoriums between 1930 and 1952. A substantial proportion (26.4 percent) had received radiation doses to the breast of 10 cGy or more from repeated fluoroscopic examinations during therapeutic pneumothoraxes. Women exposed to greater than or equal to 10 cGy of radiation had a relative risk of death from breast cancer of 1.36, as compared with those exposed to less than 10 cGy (95 percent confidence interval, 1.11 to 1.67; P = 0.001). The data were most consistent with a linear dose-response relation. The risk was greatest among women who had been exposed to radiation when they were between 10 and 14 years of age; they had a relative risk of 4.5 per gray, and an additive risk of 6.1 per 10(4) person-years per gray. With increasing age at first exposure, there was substantially less excess risk, and the radiation effect appeared to peak approximately 25 to 34 years after the first exposure. Our additive model for lifetime risk predicts that exposure to 1 cGy at the age of 40 increases the number of deaths from breast cancer by 42 per million women. We conclude that the risk of breast cancer associated with radiation decreases sharply with increasing age at exposure and that even a small benefit to women of screening mammography would outweigh any possible risk of radiation-induced breast cancer.

• OSTI ID: 5155710
• Journal Information: New England Journal of Medicine; (USA), Vol. 321:19; ISSN 0028-4793
• Country of Publication: United States
• Language: English

Related Subjects

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOMEDICAL RADIOGRAPHY
SIDE EFFECTS
MAMMARY GLANDS
NEOPLASMS
RADIOINDUCTION
TUBERCULOSIS
AGE DEPENDENCE
DOSE-RESPONSE RELATIONSHIPS
MORTALITY
RISK ASSESSMENT
BACTERIAL DISEASES
BODY
DIAGNOSTIC TECHNIQUES
DISEASES
GLANDS
INFECTIOUS DISEASES
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
560151* - Radiation Effects on Animals- Man