Risk of Secondary Malignancy After Radiotherapy for Breast Cancer: Long-term Follow-up of Japanese Patients with Breast Cancer

Overview

Journal Breast Cancer Res Treat

Specialty Oncology

Date 2022 Jul 5

PMID 35781767

Authors

Noriyuki Okonogi

Kumiko Karasawa

Yuki Nitta

Yasumasa Mori

Kazutoshi Murata

Masaru Wakatsuki

Hiroshi Tsuji

Affiliations

Soon will be listed here.

Abstract

Purpose: There have been very few reports of secondary malignancies after breast cancer treatment in Asia, particularly in Japan. This study aimed to evaluate the risk of secondary malignancies after radiotherapy (RT) in Japanese breast cancer patients.

Methods: This single-center retrospective study included patients who underwent RT between July 1961 and September 2006 for postoperative breast cancer. A total of 702 patients with a follow-up period of more than 5 years were analyzed. All malignancies observed at more than 5 years after the start of RT were defined as secondary malignancies. To calculate the relative risk (RR) of secondary malignancies, we applied data from the National Cancer Center in Japan.

Results: The median observation period was 9.7 (interquartile range 7.1-18.2) years. The cumulative person-years of observation were 6879.4. The RR of contralateral breast cancer increased by 1.85-fold (95% confidence interval [CI] 1.05-3.26) among patients compared with that among the general population; however, the difference was not significant (p = 0.053). The RR of secondary malignancies other than breast cancer increased by 2.71-fold (95% CI 1.99-3.70, p < 0.001) among the patients compared with the general population. Even when only malignancies detected more than 10 years after RT were defined as secondary malignancies, the RR of secondary malignancies other than breast cancer was 1.91 (95% CI 1.33-2.73, p < 0.001).

Conclusion: The incidence of secondary malignancies after RT may be somewhat higher in Japanese patients with breast cancer than in the general population.

Citing Articles

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Voyant C, Pinpin M, Leschi D, Prapant S, Savigny F, Acquaviva M Sci Rep. 2024; 13(1):23110.

PMID: 38172237 PMC: 10764879. DOI: 10.1038/s41598-023-50538-x.

References

Shaitelman S, Chiang Y, Griffin K, DeSnyder S, Smith B, Schaverien M . Radiation therapy targets and the risk of breast cancer-related lymphedema: a systematic review and network meta-analysis. Breast Cancer Res Treat. 2016; 162(2):201-215. DOI: 10.1007/s10549-016-4089-0. View

Ademuyiwa F, Olopade O . Racial differences in genetic factors associated with breast cancer. Cancer Metastasis Rev. 2003; 22(1):47-53. DOI: 10.1023/a:1022259901319. View

Calip G, Law E, Ko N . Racial and ethnic differences in risk of second primary cancers among breast cancer survivors. Breast Cancer Res Treat. 2015; 151(3):687-96. PMC: 4501770. DOI: 10.1007/s10549-015-3439-7. View

Terao C, Suzuki A, Momozawa Y, Akiyama M, Ishigaki K, Yamamoto K . Chromosomal alterations among age-related haematopoietic clones in Japan. Nature. 2020; 584(7819):130-135. PMC: 7489641. DOI: 10.1038/s41586-020-2426-2. View

Taylor C, Correa C, Duane F, Aznar M, Anderson S, Bergh J . Estimating the Risks of Breast Cancer Radiotherapy: Evidence From Modern Radiation Doses to the Lungs and Heart and From Previous Randomized Trials. J Clin Oncol. 2017; 35(15):1641-1649. PMC: 5548226. DOI: 10.1200/JCO.2016.72.0722. View

Grantzau T, Thomsen M, Vaeth M, Overgaard J . Risk of second primary lung cancer in women after radiotherapy for breast cancer. Radiother Oncol. 2014; 111(3):366-73. DOI: 10.1016/j.radonc.2014.05.004. View

Mohamad O, Tabuchi T, Nitta Y, Nomoto A, Sato A, Kasuya G . Risk of subsequent primary cancers after carbon ion radiotherapy, photon radiotherapy, or surgery for localised prostate cancer: a propensity score-weighted, retrospective, cohort study. Lancet Oncol. 2019; 20(5):674-685. DOI: 10.1016/S1470-2045(18)30931-8. View

Zablotska L, Neugut A . Lung carcinoma after radiation therapy in women treated with lumpectomy or mastectomy for primary breast carcinoma. Cancer. 2003; 97(6):1404-11. DOI: 10.1002/cncr.11214. View

Morton L, Dores G, Tucker M, Kim C, Onel K, Gilbert E . Evolving risk of therapy-related acute myeloid leukemia following cancer chemotherapy among adults in the United States, 1975-2008. Blood. 2013; 121(15):2996-3004. PMC: 3624944. DOI: 10.1182/blood-2012-08-448068. View

10.

Polednak A . Estimating the number of U.S. incident cancers attributable to obesity and the impact on temporal trends in incidence rates for obesity-related cancers. Cancer Detect Prev. 2008; 32(3):190-9. DOI: 10.1016/j.cdp.2008.08.004. View

11.

Tung N, Boughey J, Pierce L, Robson M, Bedrosian I, Dietz J . Management of Hereditary Breast Cancer: American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Guideline. J Clin Oncol. 2020; 38(18):2080-2106. DOI: 10.1200/JCO.20.00299. View

12.

Loibl S, von Minckwitz G, Gwyn K, Ellis P, Blohmer J, Schlegelberger B . Breast carcinoma during pregnancy. International recommendations from an expert meeting. Cancer. 2005; 106(2):237-46. DOI: 10.1002/cncr.21610. View

13.

De Vathaire F, Hardiman C, Shamsaldin A, Campbell S, Grimaud E, Hawkins M . Thyroid carcinomas after irradiation for a first cancer during childhood. Arch Intern Med. 1999; 159(22):2713-9. DOI: 10.1001/archinte.159.22.2713. View

14.

Totoki Y, Tatsuno K, Covington K, Ueda H, Creighton C, Kato M . Trans-ancestry mutational landscape of hepatocellular carcinoma genomes. Nat Genet. 2014; 46(12):1267-73. DOI: 10.1038/ng.3126. View

15.

Hooning M, Aleman B, Hauptmann M, Baaijens M, Klijn J, Noyon R . Roles of radiotherapy and chemotherapy in the development of contralateral breast cancer. J Clin Oncol. 2008; 26(34):5561-8. DOI: 10.1200/JCO.2007.16.0192. View

16.

Best T, Li D, Skol A, Kirchhoff T, Jackson S, Yasui Y . Variants at 6q21 implicate PRDM1 in the etiology of therapy-induced second malignancies after Hodgkin's lymphoma. Nat Med. 2011; 17(8):941-3. PMC: 3229923. DOI: 10.1038/nm.2407. View

17.

Pesch B, Kendzia B, Gustavsson P, Jockel K, Johnen G, Pohlabeln H . Cigarette smoking and lung cancer--relative risk estimates for the major histological types from a pooled analysis of case-control studies. Int J Cancer. 2011; 131(5):1210-9. PMC: 3296911. DOI: 10.1002/ijc.27339. View

18.

Ogo E, Komaki R, Fujimoto K, Uchida M, Abe T, Nakamura K . A survey of radiation-induced bronchiolitis obliterans organizing pneumonia syndrome after breast-conserving therapy in Japan. Int J Radiat Oncol Biol Phys. 2007; 71(1):123-31. DOI: 10.1016/j.ijrobp.2007.09.003. View

19.

Grantzau T, Overgaard J . Risk of second non-breast cancer after radiotherapy for breast cancer: a systematic review and meta-analysis of 762,468 patients. Radiother Oncol. 2014; 114(1):56-65. DOI: 10.1016/j.radonc.2014.10.004. View

20.

Quinn G, Pal T, Murphy D, Vadaparampil S, Kumar A . High-risk consumers' perceptions of preimplantation genetic diagnosis for hereditary cancers: a systematic review and meta-analysis. Genet Med. 2012; 14(2):191-200. DOI: 10.1038/gim.0b013e31822ddc7e. View