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Aggressiveness of contralateral breast cancer is influenced by radiotherapy for the first tumor.
MedLine Citation:
PMID:  23034813     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We aimed to investigate if characteristics of contralateral breast cancer (CBC) are influenced by adjuvant radiotherapy for the first breast cancer. Using information from population-based registers and medical records we analyzed two cohorts comprising all women with CBC diagnosed >3 months after their first cancer (809 patients in Stockholm 1976-2005 and 750 patients in South Sweden 1977-2005). We used Poisson regression to calculate risk of distant metastasis after CBC, comparing patients treated and not treated with radiotherapy for the first cancer. Logistic regression was used to estimate odds ratio of more aggressive tumor characteristics in the second cancer, compared to the first. For CBC-patients in Stockholm with < 5 years between the cancers radiotherapy for the first cancer conferred a nearly doubled risk of distant metastasis [IRR=1.91 (95% CI: 1.27-2.88)], compared to those not treated with radiotherapy. This was replicated in the South Swedish cohort (IRR=2.12 [95% CI: 1.40-3.23]). In Stockholm we found an increased odds that, following radiotherapy, a second cancer was of more advanced TNM-stage [OR 2.14 (95% CI: 1.12-4.07)] and higher histological grade [OR=2.14 (95% CI: 1.14-3.99)] compared to the first, for CBC-patients with < 5 years between the cancers. No effect on any of the investigated outcomes was seen for patients diagnosed with CBC > 5 years from the first cancer. In conclusion; patients diagnosed with CBC within 5 years had worse prognosis, and more aggressive tumor characteristics of the second cancer, if they had received radiotherapy for their first cancer, compared to no radiotherapy.
Authors:
Maria Ec Sandberg; Sara Alkner; Mikael Hartman; Sandra Eloranta; Lisa Rydén; Alexander Ploner; Hans-Olov Adami; Per Hall; Kamila Czene
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-4
Journal Detail:
Title:  International journal of cancer. Journal international du cancer     Volume:  -     ISSN:  1097-0215     ISO Abbreviation:  Int. J. Cancer     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0042124     Medline TA:  Int J Cancer     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 UICC.
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Maria.Sandberg@ki.se.
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