Frequency of radiation-induced malignancies post-adjuvant radiotherapy for breast cancer in patients with Li-Fraumeni syndrome
| Autor: | Payal D. Shah, Katherine L. Nathanson, Suzanne P. MacFarland, Anh N Le, Kara N. Maxwell, Heena Desai, Jacquelyn Powers, Angela R. Bradbury, Peter Gabriel, Kristin Zelley, Susan M. Domchek, Joanna Harton, Abigail Doucette, Gary M. Freedman |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
0301 basic medicine Oncology Cancer Research medicine.medical_specialty Neoplasms Radiation-Induced Adolescent medicine.medical_treatment Breast Neoplasms Malignancy Lower risk Article Li-Fraumeni Syndrome Young Adult 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine medicine Humans skin and connective tissue diseases Thyroid cancer Germ-Line Mutation Retrospective Studies business.industry Carcinoma Ductal Breast Middle Aged Prognosis medicine.disease Cancer registry Survival Rate Radiation therapy Carcinoma Lobular 030104 developmental biology Li–Fraumeni syndrome Lymphatic Metastasis 030220 oncology & carcinogenesis Female Radiotherapy Adjuvant Sarcoma Neoplasm Recurrence Local Tumor Suppressor Protein p53 business Follow-Up Studies |
| Zdroj: | Breast Cancer Res Treat |
| ISSN: | 1573-7217 0167-6806 |
| Popis: | PURPOSE: Women with Li-Fraumeni syndrome (LFS), a cancer predisposition syndrome caused by germline mutations in TP53, have an over 50% risk of developing breast cancer by age 70. Patients with LFS are at risk for radiation-induced malignancies; however, only small case series have prior investigated radiation risks in the treatment of breast cancer. We therefore aimed to investigate the risk of malignancy in breast cancer patients with LFS following adjuvant radiotherapy. METHODS: A single-institution retrospective chart review was conducted for female breast cancer patients with confirmed germline TP53 mutation. The frequency of radiation-induced malignancies in LFS patients were compared to non-LFS breast cancer cases reported in the Penn Medicine Cancer Registry via statistical analyses. RESULTS: We identified 51 female LFS breast cancer patients with 74 primary diagnoses. Fifty-seven% had a history of breast cancer only, and 25% had breast cancer as their presenting diagnosis of LFS. LFS-associated breast cancers were predominantly invasive ductal carcinoma (48%) and HER2+ (58%). Twenty patients underwent adjuvant radiotherapy with a median follow up of 12.5 (2–20) years. Of 18 patients who received radiation in a curative setting, one (6%) patient developed thyroid cancer, and one (6%) patient developed sarcoma in the radiation field. This risk for radiation-induced malignancy associated with LFS was higher for both sarcoma and thyroid cancer in comparison to our control cohort. CONCLUSIONS: We found a lower risk of radiation-induced secondary malignancies in LFS breast cancer patients than previously reported in the literature (33% risk of radiation-induced sarcoma). These findings suggest that LFS may not be an absolute contraindication for radiotherapy in breast cancer. The potential risk for locoregional recurrence without radiotherapy must be weighed against the long-term risk for radiation-induced malignancies in consideration of adjuvant radiotherapy for LFS breast cancer patients. |
| Databáze: | OpenAIRE |
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