Dose to the Contralateral Breast From Radiotherapy and Risk of Second Primary Breast Cancer in the WECARE Study

Marilyn Stovall; Susan A Smith; Bryan M Langholz; John D Boice; Roy E Shore; Michael Andersson; Thomas A Buchholz; Marinela Capanu; Leslie Bernstein; Charles F Lynch; Kathleen E Malone; Hoda Anton-Culver; Robert W Haile; Barry S Rosenstein; Anne S Reiner; Duncan C Thomas; Jonine L Bernstein; WECARE Study Collaborative Group

doi:10.1016/j.ijrobp.2008.02.040

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Dose to the Contralateral Breast From Radiotherapy and Risk of Second Primary Breast Cancer in the WECARE Study

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Dose to the Contralateral Breast From Radiotherapy and Risk of Second Primary Breast Cancer in the WECARE Study

Marilyn Stovall, Susan A Smith, Bryan M Langholz, John D Boice, Roy E Shore, Michael Andersson, Thomas A Buchholz, Marinela Capanu, Leslie Bernstein, Charles F Lynch, …

International journal of radiation oncology, biology, physics, Vol.72(4), pp.1021-1030

2008

DOI: 10.1016/j.ijrobp.2008.02.040

PMCID: PMC3782859

PMID: 18556141

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Abstract

To quantify the risk of second primary breast cancer in the contralateral breast (CB) after radiotherapy (RT) for first breast cancer. 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. 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). 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.

Secondary breast cancer

Radiation risk

Contralateral breast

Details

Title: Subtitle: Dose to the Contralateral Breast From Radiotherapy and Risk of Second Primary Breast Cancer in the WECARE Study
Creators: Marilyn Stovall - Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, Houston, TX
Susan A Smith - Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, Houston, TX
Bryan M Langholz - Department of Preventive Medicine, University of Southern California, Los Angeles, CA
John D Boice - International Epidemiology Institute, Rockville, MD
Roy E Shore - Radiation Effects Research Foundation (RERF), Hiroshima, Japan
Michael Andersson - Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
Thomas A Buchholz - Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX
Marinela Capanu - Department of Statistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Leslie Bernstein - Department of Cancer Etiology, City of Hope National Medical Center, Duarte, CA
Charles F Lynch - Department of Epidemiology, University of Iowa, Iowa City, IA
Kathleen E Malone - Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
Hoda Anton-Culver - Department of Epidemiology, University of California, Irvine, CA
Robert W Haile - Department of Preventive Medicine, University of Southern California, Los Angeles, CA
Barry S Rosenstein - Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY
Anne S Reiner - Department of Statistics, Memorial Sloan-Kettering Cancer Center, New York, NY
Duncan C Thomas - Department of Preventive Medicine, University of Southern California, Los Angeles, CA
Jonine L Bernstein - Department of Epidemiology, Memorial Sloan-Kettering Cancer Center, New York, NY
WECARE Study Collaborative Group
Resource Type: Journal article
Publication Details: International journal of radiation oncology, biology, physics, Vol.72(4), pp.1021-1030
DOI: 10.1016/j.ijrobp.2008.02.040
PMID: 18556141
PMCID: PMC3782859
NLM abbreviation: Int J Radiat Oncol Biol Phys
ISSN: 0360-3016
eISSN: 1879-355X
Publisher: Elsevier Inc
Language: English
Date published: 2008
Academic Unit: Epidemiology
Record Identifier: 9983996073702771

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