Radiation dose, chemotherapy and risk of lung cancer after breast cancer treatment

It is of particular concern to evaluate the risk of lung cancer occurrence after breast cancer treatment as women with breast cancer quite often undergo radiation therapy as part of their initial treatment and their life expectancy remains long. From a roster of 7711 women initially treated for brea...

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Bibliographic Details
Published in:Breast cancer research and treatment 2002-09, Vol.75 (1), p.15-24
Main Authors: RUBINO, Carole, DE VATHAIRE, Florent, DIALLO, Ibrahima, SHAMSALDIN, Akthar, GRIMAUD, Emmanuel, LABBE, Martine, CONTESSO, Genevieve, LE, Monique
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Breast cancer
Breast Neoplasms - drug therapy
Breast Neoplasms - radiotherapy
Breast Neoplasms - surgery
Cancer research
Cancer therapies
Case-Control Studies
Chemotherapy, Adjuvant
Cohort Studies
Dose-Response Relationship, Radiation
Female
Gynecology. Andrology. Obstetrics
Humans
Lung cancer
Lung Neoplasms - etiology
Mammary gland diseases
Medical sciences
Middle Aged
Neoplasms, Radiation-Induced - pathology
Radiotherapy - adverse effects
Risk Factors
Survivors
Tumors
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Summary:It is of particular concern to evaluate the risk of lung cancer occurrence after breast cancer treatment as women with breast cancer quite often undergo radiation therapy as part of their initial treatment and their life expectancy remains long. From a roster of 7711 women initially treated for breast cancer between 1954 and 1984, a cohort-study was performed among 4171 1-year survivors followed during the period 1975-1995. The relationship between the radiation dose received by the lung and the risk of lung cancer was then evaluated in a nested case-control study of 11 breast-cancer patients who developed lung cancer and 22 controls matched for age at diagnosis of breast cancer, period of initial treatment and length of follow-up. Among the 4171 women, six developed lung cancer during the entire follow-up as compared to 5.4 cases expected (SIR = 1.1, 95% CI: 0.4-2.3). When considering only the women initially treated by radiotherapy with or without adjunction of chemotherapy and excluding the 10 first years of follow-up, the SIR was significantly increased (SIR = 3.2, 95%CI: 1.0-7.4). In the case-control study, nine of the 11 lung cancers occurred in the ipsilateral lung and two in the trachea. The overall odds ratio (OR) of lung cancer associated with initial radiotherapy was 1.4 (95% CI: 0.2-11.1) and an excess in the OR of 7% (90% CI: ? to 41%, p = 0.10) per gray delivered to the site of lung cancer was evidenced. Our results agree with previous studies in favor of an increased risk of lung cancer after radiation therapy for breast cancer.
ISSN:0167-6806
1573-7217
DOI:10.1023/A:1016590315382