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Int J Radiat Oncol Biol Phys. 2008 Nov 15;72(4):1021-30. doi: 10.1016/j.ijrobp.2008.02.040. Epub 2008 Jun 14.

Dose to the contralateral breast from radiotherapy and risk of second primary breast cancer in the WECARE study.

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  • 1Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

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 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.

PMID:
18556141
[PubMed - indexed for MEDLINE]
PMCID:
PMC3782859
Free PMC Article
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