Second solid cancers after radiotherapy for breast cancer in SEER cancer registries

Gonzalez, Berrington A. De; Curtis, Rochelle E.; Gilbert, Ethel S.; Berg, Christine D.; Smith, Susan A.; Stovall, Marilyn; Ron, Elaine

doi:10.1038/sj.bjc.6605435

Cited by 219 publications

(180 citation statements)

References 28 publications

(33 reference statements)

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“…16 It is possible that organ-specific radiation doses also depended upon age, but as information on risk (expected and observed numbers) was not available for both age at diagnosis (treatment) and time since treatment, there was no stratification by age, and age is thus a potential confounder. However, in the detailed analysis of the risk of a second, contralateral, breast cancer after radiotherapy for breast cancer, using the same dataset with rather longer follow-up, 6 adjustment for age seemed to make only a small difference to the risk of second malignancy due to radiotherapy, as estimated by the ratio of the standardised incidence ratios. …”

Section: Risk Due To Radiotherapymentioning

confidence: 96%

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The cancer burden in the United Kingdom in 2007 due to radiotherapy

Maddams

Dm²,

Darby

2011

Intl Journal of Cancer

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The number of long-term cancer survivors in the general population of the UK is substantial and increasing rapidly. Many cancer survivors have been treated with radiotherapy but the likely number of radiotherapy-related second cancers has not previously been estimated. We used estimates of the numbers of cancer survivors in the UK at the beginning of 2007, in conjunction with estimates of the relative risk of a second primary cancer associated with previous radiotherapy from the United States Surveillance Epidemiology and End Results (SEER) programme, to estimate the numbers of incident cancers in the UK in 2007 that were associated with radiotherapy for a previous cancer and that may have been caused by it. We estimated that 1,346 cases of cancer, or about 0.45% of the 298,000 new cancers registered in the UK in 2007, were associated with radiotherapy for a previous cancer. The largest numbers of radiotherapy-related second cancers were lung cancer (23.7% of the total), oesophageal cancer (13.3%), and female breast cancer (10.6%); 54% of radiotherapy-related second cancers were in individuals aged 75 or over. The highest percentages of second cancers related to radiotherapy were among survivors of Hodgkin's disease and cancers of the oral cavity and pharynx and cervix uteri; over 15% of second cancers among these survivors were associated with radiotherapy for the first cancer. These calculations, which involve a number of assumptions and approximations, provide a reasonable, if conservative, estimate of the fraction of incident cancers in the UK that are attributable to past radiation therapy.Around 3% of the UK population are cancer survivors, with the total number now around two million and increasing by 3% per annum. 1 The increasing trend is partly the consequence of an ageing population but also the result of the successful use of several types of therapy, including radiotherapy. For many cancers, treatment with radiotherapy involves some incidental irradiation of the surrounding normal tissues, thus increasing the risk of a radiation-induced second cancer. Up until now, estimates of the radiation exposure of the UK population have not included exposure from radiotherapy, 2,3 and the total number of cancers in the UK population associated with past radiation exposure from radiotherapy has not previously been assessed.The largest study evaluating the risk of second cancers is the follow-up of more than two million cancer cases registered within the United States Surveillance Epidemiology and End Results (SEER) programme from 1973-2000, 390,000 of whom had survived 10 years or more. 4 That study provides, for several cancer sites, the risk of developing a second primary cancer at varying intervals after diagnosis of the initial cancer in individuals who have, and who have not, received radiotherapy. We used the SEER data, in conjunction with estimates of the numbers of survivors of different cancers in the UK at the beginning of 2007, to estimate the number of incident cancers in the UK during 2007 that wer...

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Section: Risk Due To Radiotherapymentioning

confidence: 96%

“…Therefore, we used data on the risk of contralateral breast cancer, in breast cancer survivors, by time since diagnosis, as reported by Berrington de Gonzalez et al (2010). 6 …”

Section: Multiple Primary Cancersmentioning

confidence: 99%

The cancer burden in the United Kingdom in 2007 due to radiotherapy

Maddams

Dm²,

Darby

2011

Intl Journal of Cancer

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“…La naturaleza retrospectiva de nuestro estudio no permite evaluar de forma estandarizada la toxicidad a largo plazo de la radioterapia. El número reducido de pacientes analizados no permite evaluar con certeza la incidencia de neoplasias radio-inducidas, observamos, sin embargo, que dos pacientes desarrollaron cáncer pulmonar escamoso, lo que representa una tasa mayor a la esperada para la población general 33 .…”

Section: Discussionunclassified

Cáncer de mama en mujeres adultas mayores, características clínicas e histopatológicas y resultados del tratamiento con intención curativa

Bakal

et al. 2013

Rev. méd. Chile

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“…The above-mentioned hormonotherapy as well as cytotoxic and radiation therapy used in breast cancer patients can increase the risk of occurrence of second malignancies [3,4,6,20,22,24,26,36,37,[39][40][41][42][43][44][45][46].…”

Section: Discussionmentioning

confidence: 99%

The characteristics of breast cancer patients with metachronous primary malignancies

Sas-Korczyńska¹,

Kamzol²,

Kołodziej-Rzepa³

et al. 2017

Nowotwory. Journal of Oncology

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Introduction. The risk of developing subsequent primary cancers varies from 1% to 18% and it depends on the type of first cancer and treatment methods applied. Considering the time of occurrence, multiple primary cancers generally fall into two categories: synchronous and metachronous. In breast cancer patients, 10.5% developed multiple primary cancers, from which 23.8% had synchronous, 79% had metachronous and the remaining 2.8% had both synchronous and metachronous malignancies. In patients with breast cancer, elevated risk is observed especially in the development of contralateral breast cancer, endometrial cancer, esophageal cancer, ovarian cancer and thyroid cancer. Aim. This paper presented the characteristics of breast cancer patients with metachronous primary malignancies in relation to the type of metachronous primaries (breast versus non-breast) and to analyse the impact of the type of metachronous cancers on survival rate. Material and methods. Among patients treated for breast cancer between 1963 and 2010, 354 patients (2.1%) developed metachronous primary malignancies and these made up 13.8% of all patients with multiple primary cancers. The mean age at diagnosis of the first breast cancer was 53 ± 11.5 years; positive family cancer history was noted in 127 patients (35.9%). Metachronous malignancies are defined as primaries following the diagnosis of breast cancer in a time interval greater than or equal to than 6 months. In our group, the mean time interval between the diagnosis of breast cancer and the appearance of metachronous malignancies was 100.9 ± 74.9 months (range: 6-543 months, median: 83 months). For comparison of the two groups (patients with second breast vs non-breast cancer) we used the Pearson's Chi-square test for independence (for categorized variables) and variance analysis with Student's t-test (for continuous variables). The survival rate was evaluated with the Kaplan-Meier method, and the log rank test was applied to assess the influence of some factors on the evaluated results. The significance level at α = 0.05 was adopted for all statistical analyses. Results. The probability of occurrence of new cancer averaged from 38.1% to 67.8% for 5 and 10 years after diagnosis of first breast cancer, respectively. In our group, 380 cases of metachronous carcinomas were noted in 354 analysed patients. The most frequent metachronous malignancy was breast cancer (194 cases -54.8%), which occurred as second (192 cases) or third (2 cases) cancer. Patients with contralateral breast cancer in comparison to other types of metachronous malignancies were significantly (p < 0.05): younger (under 50 years: 56.2% vs 34.4%), premenopausal (69.6% vs 48.8%), had a lobular type of first breast cancer (6.7% vs 1.3%), and rarely received tamoxifen (25.3% vs 48.2%). The type of metachronous cancers significantly influenced survival rate: 10-year overall survival rates were 80.1% vs 67.8%, (p = 0.0271). Conclusions. The risk of occurrence of second malignancies in breast cancer survivors makes early dete...

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Second solid cancers after radiotherapy for breast cancer in SEER cancer registries

Cited by 219 publications

References 28 publications

The cancer burden in the United Kingdom in 2007 due to radiotherapy

The cancer burden in the United Kingdom in 2007 due to radiotherapy

Cáncer de mama en mujeres adultas mayores, características clínicas e histopatológicas y resultados del tratamiento con intención curativa

The characteristics of breast cancer patients with metachronous primary malignancies

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