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Influence of radiotherapy for the first tumor on aggressiveness of contralateral breast cancer

Sandberg, Maria E. C. LU ; Alkner, Sara LU ; Hartman, Mikael ; Eloranta, Sandra ; Rydén, Lisa LU orcid ; Ploner, Alexander ; Adami, Hans-Olov ; Hall, Per and Czene, Kamila (2013) In International Journal of Cancer 132(10). p.2388-2394
Abstract
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 19762005 and 750 patients in South Sweden 19772005). 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 with... (More)
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 19762005 and 750 patients in South Sweden 19772005). 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 with <5 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): 1.272.88], compared to those not treated with radiotherapy. This was replicated in the South Swedish cohort [IRR = 2.12 (95% CI: 1.403.23)]. In Stockholm, we found an increased odds that, following radiotherapy, a second cancer was of more advanced TNM-stage [OR 2.16 (95% CI 1.134.11)] and higher histological grade [OR = 2.00 (95% CI 1.083.72)] compared to the first, for patients with CBC 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. (Less)
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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
contralateral breast cancer (CBC), adjuvant radiotherapy, prognosis, tumor characteristics, cancer epidemiology
in
International Journal of Cancer
volume
132
issue
10
pages
2388 - 2394
publisher
John Wiley & Sons Inc.
external identifiers
  • wos:000315512300016
  • scopus:84874939098
  • pmid:23034813
ISSN
0020-7136
DOI
10.1002/ijc.27890
language
English
LU publication?
yes
id
fe83133d-5b6a-485d-9e0b-9a68b554d89a (old id 3651193)
date added to LUP
2016-04-01 10:25:13
date last changed
2024-01-06 16:10:26
@article{fe83133d-5b6a-485d-9e0b-9a68b554d89a,
  abstract     = {{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 &gt;3 months after their first cancer (809 patients in Stockholm 19762005 and 750 patients in South Sweden 19772005). 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 with &lt;5 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): 1.272.88], compared to those not treated with radiotherapy. This was replicated in the South Swedish cohort [IRR = 2.12 (95% CI: 1.403.23)]. In Stockholm, we found an increased odds that, following radiotherapy, a second cancer was of more advanced TNM-stage [OR 2.16 (95% CI 1.134.11)] and higher histological grade [OR = 2.00 (95% CI 1.083.72)] compared to the first, for patients with CBC with &lt;5 years between the cancers. No effect on any of the investigated outcomes was seen for patients diagnosed with CBC &gt;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.}},
  author       = {{Sandberg, Maria E. C. and Alkner, Sara and Hartman, Mikael and Eloranta, Sandra and Rydén, Lisa and Ploner, Alexander and Adami, Hans-Olov and Hall, Per and Czene, Kamila}},
  issn         = {{0020-7136}},
  keywords     = {{contralateral breast cancer (CBC); adjuvant radiotherapy; prognosis; tumor characteristics; cancer epidemiology}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{2388--2394}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Cancer}},
  title        = {{Influence of radiotherapy for the first tumor on aggressiveness of contralateral breast cancer}},
  url          = {{http://dx.doi.org/10.1002/ijc.27890}},
  doi          = {{10.1002/ijc.27890}},
  volume       = {{132}},
  year         = {{2013}},
}