Treatment, toxicity, and mortality after subsequent breast cancer in female survivors of childhood cancer Journal Article
| Authors: | Im, C.; Hasan, H.; Stene, E.; Monick, S.; Rader, R. K.; Sheade, J.; Wolfe, H.; Lu, Z.; Spector, L. G.; McDonald, A. J.; Nolan, V.; Arnold, M. A.; Conces, M. R.; Moskowitz, C. S.; Henderson, T. O.; Robison, L. L.; Armstrong, G. T.; Yasui, Y.; Nanda, R.; Oeffinger, K. C.; Neglia, J. P.; Blaes, A.; Turcotte, L. M. |
| Article Title: | Treatment, toxicity, and mortality after subsequent breast cancer in female survivors of childhood cancer |
| Abstract: | Childhood cancer survivors, particularly those who received chest radiotherapy, are at high risk for developing subsequent breast cancer. Minimizing long-term toxicity risks associated with additional radiotherapy and chemotherapy is a priority, but therapeutic tradeoffs have not been comprehensively characterized and their impact on survival is unknown. In this study, 431 female childhood cancer survivors with subsequent breast cancer from a multicenter retrospective cohort study were evaluated. Compared with one-to-one matched females with first primary breast cancer, survivors are as likely to be prescribed guideline-concordant treatment (N = 344 pairs; survivors: 94%, controls: 93%), but more frequently undergo mastectomy (survivors: 81%, controls: 60%) and are less likely to be treated with anthracyclines (survivors: 47%, controls: 66%) or radiotherapy (survivors: 18%, controls: 61%). Despite this, survivors have nearly 3.5-fold (95% CI = 2.17-5.57) greater mortality risk. Here, we show survivors with subsequent breast cancer face excess mortality despite therapeutic tradeoffs and require specialized treatment guidelines. © The Author(s) 2025. |
| Keywords: | survival; adolescent; adult; cancer chemotherapy; child; controlled study; middle aged; leukemia; survival rate; retrospective studies; young adult; major clinical study; clinical trial; mortality; doxorubicin; chemotherapy; neurotoxicity; breast cancer; mastectomy; radiotherapy; cohort analysis; cyclophosphamide; breast neoplasms; retrospective study; risk factor; childhood cancer; hodgkin disease; cancer survivor; sarcoma; gastrointestinal toxicity; multicenter study; cardiotoxicity; breast tumor; estrogen receptor; health risk; toxicity; anthracycline; anthracyclines; cytopenia; treatment refusal; therapy; disease treatment; lumpectomy; cumulative incidence; cancer survivors; adverse event; latent period; childhood cancer survivor; cancer; humans; human; female; article; excess mortality; treatment guideline; mortality risk; all cause mortality; breast radiotherapy |
| Journal Title: | Nature Communications |
| Volume: | 16 |
| ISSN: | 2041-1723 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2025-03-31 |
| Start Page: | 3088 |
| Language: | English |
| DOI: | 10.1038/s41467-025-58434-w |
| PUBMED: | 40164623 |
| PROVIDER: | scopus |
| PMCID: | PMC11958683 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Source: Scopus |
