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Breast cancer risk linked to chest irradiation during Childhood

To: radsafe <radsafe@list.vanderbilt.edu>, know_nukes@yahoogroups.com
Subject: Breast cancer risk linked to chest irradiation during Childhood
From: John Jacobus <crispy_bird@YAHOO.COM>
Date: Fri, 29 Oct 2004 15:04:33 -0700 (PDT)
Reply-To: John Jacobus <crispy_bird@YAHOO.COM>
Sender: owner-radsafe@list.vanderbilt.edu

Breast cancer risk linked to chest irradiation during

childhood

10/25/2004

By: Reuters Health

NEW YORK (Reuters Health), Oct 25 - Women who have

survived childhood cancer have an increased risk of

breast cancer compared with other women their age, the

results of the Childhood Cancer Survivor Study reveal.

While the risk appears to be highest among those

treated with chest radiation therapy, patients who

were not irradiated also have a nearly fivefold risk

compared with the general population.

"Women who survived childhood cancer and had sarcoma,

chest irradiation, family history of breast cancer, or

personal history of thyroid disease should consider

early, vigilant screening for breast cancer," Dr. Lisa

B. Kenney and colleagues recommend in their paper,

published in the October 19th issue of the Annals of

Internal Medicine.

The study cohort consisted of 6068 women diagnosed

before age 21, treated between 1970 and 1986 at one of

25 collaborating institutions, and who survived for at

least 5 years. Ninety-five women had 111 confirmed

cases of breast cancer at a median age of 35 years. Of

23 women who did not survive, 15 died of breast

cancer.

Sixty-five women were Hodgkin's disease survivors, 63

of whom received chest radiation therapy. Eighteen had

bone or soft-tissue sarcoma, while the remainder had

been diagnosed with non-Hodgkin lymphoma, Wilms tumor,

leukemia, or brain tumors.

For those treated with chest radiation, the

standardized incidence ratio for breast cancer was

24.7. For the 20 subjects who had not been treated

with chest irradiation, the incidence ratio was 4.8.

Other significant risk factors were a family history

of breast cancer (relative rate (RR) = 2.7), family

history of sarcoma (RR = 5.0), and history of thyroid

disease (RR = 1.7).

Risk was not affected by age at menarche or first live

birth, age at original diagnosis, or exposure to

alkylating agents. Exposure to pelvic radiation was

actually associated with a decreased risk (RR = 0.6, p

= 0.03).

"Secondary breast cancer risk should be assessed in

all young women who are childhood cancer survivors,

with particular attention to survivors of sarcoma and

those treated with previous chest radiation therapy,"

Dr. Kenney's group concludes.

Last Updated: 2004-10-25 10:51:20 -0400 (Reuters

Health)

Ann Intern Med 2004;141:590-597.