Journal article
Risk of treatment-related esophageal cancer among breast cancer survivors
Annals of oncology, Vol.23(12), pp.3081-3091
12/2012
DOI: 10.1093/annonc/mds144
PMCID: PMC3501231
PMID: 22745217
Abstract
Radiotherapy for breast cancer may expose the esophagus to ionizing radiation, but no study has evaluated esophageal cancer risk after breast cancer associated with radiation dose or systemic therapy use.
Nested case–control study of esophageal cancer among 289 748 ≥5-year survivors of female breast cancer from five population-based cancer registries (252 cases, 488 individually matched controls), with individualized radiation dosimetry and information abstracted from medical records.
The largest contributors to esophageal radiation exposure were supraclavicular and internal mammary chain treatments. Esophageal cancer risk increased with increasing radiation dose to the esophageal tumor location (Ptrend < 0.001), with doses of ≥35 Gy associated with an odds ratio (OR) of 8.3 [95% confidence interval (CI) 2.7–28]. Patients with hormonal therapy ≤5 years preceding esophageal cancer diagnosis had lower risk (OR = 0.4, 95% CI 0.2–0.8). Based on few cases, alkylating agent chemotherapy did not appear to affect risk. Our data were consistent with a multiplicative effect of radiation and other esophageal cancer risk factors (e.g. smoking).
Esophageal cancer is a radiation dose-related complication of radiotherapy for breast cancer, but absolute risk is low. At higher esophageal doses, the risk warrants consideration in radiotherapy risk assessment and long-term follow-up.
Details
- Title: Subtitle
- Risk of treatment-related esophageal cancer among breast cancer survivors
- Creators
- L.M Morton - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USAE.S Gilbert - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USAP Hall - Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, SwedenM Andersson - Department of Oncology, Copenhagen University Hospital, Copenhagen, DenmarkH Joensuu - Department of Oncology, Helsinki University Central Hospital and University of Helsinki, Helsinki, FinlandL Vaalavirta - Department of Oncology, Helsinki University Central Hospital and University of Helsinki, Helsinki, FinlandG.M Dores - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USAM Stovall - Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USAE.J Holowaty - Dalla Lana School of Public Health, University of Toronto, Toronto, CanadaC.F Lynch - Department of Epidemiology, University of Iowa, Iowa City, USAR.E Curtis - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USAS.A Smith - Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USAR.A Kleinerman - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USAM Kaijser - Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, SwedenH.H Storm - Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, DenmarkE Pukkala - Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandR.E Weathers - Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USAM.S Linet - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USAP Rajaraman - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USAJ.F Fraumeni - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USAL.M Brown - Statistics & Epidemiology, RTI International, Rockville, USAF.E van Leeuwen - Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The NetherlandsS.D Fossa - Department of Oncology, Oslo University Hospital and University of Oslo, Oslo, NorwayT.B Johannesen - Cancer Registry of Norway, Oslo, NorwayF Langmark - Cancer Registry of Norway, Oslo, NorwayS Lamart - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USAL.B Travis - Department of Radiation Oncology, University of Rochester Medical Center, Rochester, USAB.M.P Aleman - Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Resource Type
- Journal article
- Publication Details
- Annals of oncology, Vol.23(12), pp.3081-3091
- Publisher
- Elsevier Ltd
- DOI
- 10.1093/annonc/mds144
- PMID
- 22745217
- PMCID
- PMC3501231
- ISSN
- 0923-7534
- eISSN
- 1569-8041
- Grant note
- name: Intramural Research Program of the National Cancer Institute; DOI: 10.13039/100000002, name: National Institutes of Health; name: Department of Health and Human Services; name: National Cancer Institute contracts to Cancer Care Ontario, Toronto, Canada, award: NO1-CP-31157; name: Danish Cancer Society, Copenhagen, Denmark, award: NO1-CP-31019; name: Finnish Cancer Registry, Helsinki, Finland, award: NO1-CP-31154; name: Information Management Services, Inc., Silver Spring, USA, award: N01-CP-31003; name: Karolinska Institute, Stockholm, Sweden, award: NO1-CP-31156; name: University of Iowa, Iowa City, USA, award: NO1-CP-31155; name: The University of Texas MD Anderson Cancer Center, Houston, USA, award: N02-CP-55503; name: Westat, Inc., Rockville, USA, award: N02-CP-31136
- Language
- English
- Date published
- 12/2012
- Academic Unit
- Epidemiology
- Record Identifier
- 9983995115102771
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