Influence of radiotherapy for the first tumor on aggressiveness of contralateral breast cancer
Autor: | Lisa Rydén, Hans-Olov Adami, Sara Alkner, Sandra Eloranta, Mikael Hartman, Kamila Czene, Alexander Ploner, Maria E C Sandberg, Per Hall |
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Rok vydání: | 2012 |
Předmět: |
Oncology
Adult Cancer Research medicine.medical_specialty medicine.medical_treatment Population Breast Neoplasms Cohort Studies symbols.namesake Breast cancer Internal medicine parasitic diseases Epidemiology of cancer medicine Odds Ratio Humans Poisson regression Poisson Distribution education Aged Neoplasm Staging Sweden education.field_of_study business.industry Medical record Incidence Cancer Neoplasms Second Primary Radiotherapy Dosage Odds ratio Middle Aged medicine.disease Prognosis Radiation therapy symbols Female Radiotherapy Adjuvant Neoplasm Grading business |
Zdroj: | International journal of cancer. 132(10) |
ISSN: | 1097-0215 |
Popis: | 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 diagnosed3 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 (OR) of more aggressive tumor characteristics in the second cancer, compared to the first. For patients with CBC in Stockholm with5 years between the cancers radiotherapy for the first cancer conferred a nearly doubled risk of distant metastasis [incidence rate ratio (IRR) = 1.91; 95% confidence interval (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 2.16 (95% CI 1.13-4.11)] and higher histological grade [OR = 2.00 (95% CI 1.08-3.72)] compared to the first, for patients with CBC with5 years between the cancers. No effect on any of the investigated outcomes was seen for patients diagnosed with CBC5 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. |
Databáze: | OpenAIRE |
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