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


Authors: Stovall, M.; Smith, S. A.; Langholz, B. M.; Boice, J. D. Jr; Shore, R. E.; Andersson, M.; Buchholz, T. A.; Capanu, M.; Bernstein, L.; Lynch, C. F.; Malone, K. E.; Anton-Culver, H.; Haile, R. W.; Rosenstein, B. S.; Reiner, A. S.; Thomas, D. C.; Bernstein, J. L.
Article 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 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. © 2008 Elsevier Inc. All rights reserved.
Keywords: controlled study; treatment outcome; middle aged; major clinical study; dose response; united states; radiation dose; follow up; breast cancer; radiotherapy dosage; radiotherapy; incidence; risk factors; breast neoplasms; groups by age; risk assessment; confidence interval; confidence intervals; cancer center; dosimetry; neoplasms, radiation-induced; relative biological effectiveness; neoplasms, second primary; regression analysis; body burden; logistic regression analysis; denmark; radiation treatments; women's health; risk perception; breast cancers; contralateral breast; radiation risk; secondary breast cancer; electric circuit breakers; absorbed doses; age at exposures; asynchronous; bilateral breast cancers; cancer.; dose dependents; dose responses; environmental; great-er; logistic regression models; multivariable; radiation doses; rate ratios
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 72
Issue: 4
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2008-11-15
Start Page: 1021
End Page: 1030
Language: English
DOI: 10.1016/j.ijrobp.2008.02.040
PUBMED: 18556141
PROVIDER: scopus
PMCID: PMC3782859
DOI/URL:
Notes: --- - "Cited By (since 1996): 26" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Anne S Reiner
    125 Reiner
  2. Marinela Capanu
    211 Capanu
  3. Jonine L Bernstein
    104 Bernstein