Breast cancer after childhood irradiationClinical and diagnosis characteristics of breast cancers in women with a history of radiotherapy in the first 30 years of life: A French multicentre cohort study
Section snippets
Selection of patients and data collection
Patients were recruited from eight French centres, who were able to do an exhaustive research in medical files and from the French patients of the Euro2K database, which is a cohort of childhood solid cancer survivor [19], [24]. To be included, women should have all these inclusion criteria: a personal past history of treatment for cancer before 30 years of age, and, who had received radiotherapy at a dose of ≥3 Gy over all or part of the breast, and, who developed SBC at ≤50 years of age. This
Characteristics of the initial cancer
One hundred and four women (≤50-year of age) with 121 breast tumours were included in the study (67 from the eight centres and 37 from the Euro2k cohort). Mean age at diagnosis of the initial cancer was 16.3 years (range: 0.6–30.6); this was HL in 71% of cases. The initial cancer was treated between 1950 and 1995 with a total dose of ≥3 Gy over at least part of the breast, in 6–27 sessions spread over 3 days to 6 weeks. The majority of patients received radiotherapy to the mediastinum at a dose of
Discussion
In our cohort of 104 women, only 17.5% were previously followed up for this risk, although they had received radiotherapy for a cancer during their childhood or young adulthood. In contrast to the North American patients described by Elkin [26], SBCs in our patients were rarely diagnosed during screening, but usually at a symptomatic stage (88.3%) and no patient benefited from MRI screening.
SBC presented in women as young as 25 years (except one at 16 years) with a mean age at SBC diagnosis of 37
Funding
This work was funded by the Association pour la Recherche sur le Cancer (ARC Fundation), the Agence Nationale pour la Recherche Scientifique (ANR, Hope-Epi).
Conflicts of interest
All authors declare no conflict of interest.
References (35)
- et al.
Breast cancer occurred after treatment for Hodgkin’s disease: analysis of 133 cases
Radiother Oncol
(2001) - et al.
Ongoing improvement in long-term survival of patients with Hodgkin disease at all ages and recent catch-up of older patients
Blood
(2008) - et al.
Morbidity and mortality in long-term survivors of Hodgkin lymphoma: a report from the Childhood Cancer Survivor Study
Blood
(2011) - et al.
An imrt technique to increase therapeutic ratio of breast irradiation in patients with early-stage left breast cancer: limiting second malignancies
Med Dosim
(2008) - et al.
Radiation dose and long term risk of cardiac pathology following radiotherapy and anthracyclin for a childhood cancer
Radiother Oncol
(2006) - et al.
Management of radiation-induced sarcomas in a tertiary referral centre: a review of 25 cases
Breast
(2010) - et al.
Radiation-induced osteosarcomas in the pediatric population
Int J Radiat Oncol Biol Phys
(2005) - et al.
Breast cancer risk following radiotherapy for Hodgkin lymphoma: modification by other risk factors
Blood
(2005) - et al.
Risk of a second malignant neoplasm after cancer in childhood treated with radiotherapy: correlation with the integral dose restricted to the irradiated fields
Int J Radiat Oncol Biol Phys
(2008) - et al.
Retrospective reconstructions of active bone marrow dose-volume histograms
Int J Radiat Oncol Biol Phys
(2014)
Second primary cancers in survivors of childhood cancer
Lancet
Recommendations for breast cancer surveillance for female survivors of childhood, adolescent, and young adult cancer given chest radiation: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group
Lancet Oncol
Towards an improvement of the quality of life after radiotherapy in children
Bull Cancer
Breast cancer after radiotherapy: risk factors and suggestion for breast delineation as an organ at risk in the prepuberal girl
Cancer Radiother
Subsequent neoplasms in 5-year survivors of childhood cancer: the Childhood Cancer Survivor Study
J Natl Cancer Inst
Chronic health conditions in adult survivors of childhood cancer
N Engl J Med
Breast cancer following multiple fluoroscopies during artificial pneumothorax treatment of pulmonary tuberculosis
Can Med Assoc J
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