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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2017

01-11-2017 | Epidemiology

Radiotherapy for ductal carcinoma in situ and risk of second non-breast cancers

Authors: Diana R. Withrow, Lindsay M. Morton, Rochelle E. Curtis, Sara J. Schonfeld, Amy Berrington de González

Published in: Breast Cancer Research and Treatment | Issue 1/2017

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Abstract

Purpose

Radiotherapy for ductal carcinoma (DCIS) is increasing, but the risks and benefits of the treatment remain uncertain. We aimed to investigate the relationship between radiotherapy for DCIS and risk of second non-breast cancers in a large US cohort.

Methods

We conducted a retrospective cohort study of 52,556 women in 12 U.S. population-based cancer registries diagnosed with first primary DCIS during 1992–2008 at age 25–79 years. We estimated relative risks (RRs), attributable risks (AR), and excess absolute risks (EAR) of second non-breast cancers associated with radiotherapy using Poisson regression adjusted for age at year of diagnosis, grade, hormonal therapy (yes/no or unknown), and time since diagnosis.

Results

Approximately half of the women (46.3%) received radiotherapy. Radiotherapy was associated with an increased risk of all second non-breast cancers combined [RR 1.17, 95% confidence interval (CI) 1.08–1.28] and all in-field, radiation-related second cancers combined (RR 1.37, 95% CI 1.15–1.63), driven by second lung cancers (RR 1.33, 95% CI 1.10–1.60) and non-CLL leukemia (RR 1.71, 95% CI 1.02–2.86). The estimated cumulative excess risk of all second non-breast cancers was 0.8% by 15 years after DCIS diagnosis.

Conclusions

Radiotherapy was associated with an increased risk of second non-breast cancers. The specific excess of cancers at sites likely in/near the radiotherapy field suggests the findings are unlikely due exclusively to confounding, but further research into factors related to receipt of radiotherapy is needed. Our risk estimates can be used to help assess the balance of the risks and benefits of radiotherapy for DCIS and to inform clinical practice.
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Metadata
Title
Radiotherapy for ductal carcinoma in situ and risk of second non-breast cancers
Authors
Diana R. Withrow
Lindsay M. Morton
Rochelle E. Curtis
Sara J. Schonfeld
Amy Berrington de González
Publication date
01-11-2017
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2017
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-017-4410-6

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