Breast cancer after chest radiation therapy for childhood cancer Journal Article
| Authors: | Moskowitz, C. S.; Chou, J. F.; Wolden, S. L.; Bernstein, J. L.; Malhotra, J.; Friedman, D. N.; Mubdi, N. Z.; Leisenring, W. M.; Stovall, M.; Hammond, S.; Smith, S. A.; Henderson, T. O.; Boice, J. D.; Hudson, M. M.; Diller, L. R.; Bhatia, S.; Kenney, L. B.; Neglia, J. P.; Begg, C. B.; Robison, L. L.; Oeffinger, K. C. |
| Article Title: | Breast cancer after chest radiation therapy for childhood cancer |
| Abstract: | Purpose: The risk of breast cancer is high in women treated for a childhood cancer with chest irradiation. We sought to examine variations in risk resulting from irradiation field and radiation dose. Patients and Methods: We evaluated cumulative breast cancer risk in 1,230 female childhood cancer survivors treated with chest irradiation who were participants in the CCSS (Childhood Cancer Survivor Study). Results: Childhood cancer survivors treated with lower delivered doses of radiation (median, 14 Gy; range, 2 to 20 Gy) to a large volume (whole-lung field) had a high risk of breast cancer (standardized incidence ratio [SIR], 43.6; 95% CI, 27.2 to 70.3), as did survivors treated with high doses of delivered radiation (median, 40 Gy) to the mantle field (SIR, 24.2; 95% CI, 20.7 to 28.3). The cumulative incidence of breast cancer by age 50 years was 30% (95% CI, 25 to 34), with a 35% incidence among Hodgkin lymphoma survivors (95% CI, 29 to 40). Breast cancer-specific mortality at 5 and 10 years was 12% (95% CI, 8 to 18) and 19% (95% CI, 13 to 25), respectively. Conclusion: Among women treated for childhood cancer with chest radiation therapy, those treated with whole-lung irradiation have a greater risk of breast cancer than previously recognized, demonstrating the importance of radiation volume. Importantly, mortality associated with breast cancer after childhood cancer is substantial. © 2014 by American Society of Clinical Oncology. |
| Keywords: | adolescent; adult; cancer chemotherapy; child; controlled study; treatment outcome; leukemia; bone tumor; major clinical study; cancer risk; multimodality cancer therapy; cancer radiotherapy; radiation dose; cancer diagnosis; breast cancer; alkylating agent; brca1 protein; brca2 protein; cancer mortality; central nervous system tumor; childhood cancer; hodgkin disease; radiation exposure; cancer survivor; nonhodgkin lymphoma; whole body radiation; neuroblastoma; dosimetry; long term care; soft tissue sarcoma; cancer epidemiology; intraductal carcinoma; longitudinal study; nephroblastoma; thorax; standardized incidence ratio; tumor invasion; whole lung irradiation; human; female; priority journal; article; thorax radiation |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 32 |
| Issue: | 21 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2014-07-20 |
| Start Page: | 2217 |
| End Page: | 2223 |
| Language: | English |
| DOI: | 10.1200/jco.2013.54.4601 |
| PROVIDER: | scopus |
| PMCID: | PMC4100937 |
| PUBMED: | 24752044 |
| DOI/URL: | |
| Notes: | Export Date: 2 September 2014 -- CODEN: JCOND -- Source: Scopus |
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