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" |
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