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Wang X, Zeng M, Ju X, Lin A, Zhou C, Shen J, Liu Z, Tang B, Cheng Q, Wang Y, Zhang J, Luo P. Correlation between second and first primary cancer: systematic review and meta-analysis of 9 million cancer patients. Br J Surg 2024; 111:znad377. [PMID: 38055899 DOI: 10.1093/bjs/znad377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/30/2023] [Accepted: 10/21/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Many survivors of a first primary cancer (FPCs) are at risk of developing a second primary cancer (SPC), with effects on patient prognosis. Primary cancers have different frequencies of specific SPC development and the development of SPCs may be closely related to the FPC. The aim of this study was to explore possible correlations between SPCs and FPCs. METHODS Relevant literature on SPCs was retrospectively searched and screened from four databases, namely, PubMed, EMBASE, Web of Science, and PMC. Data on the number of patients with SPC in 28 different organ sites were also collected from The Surveillance, Epidemiology, and End Results (SEER) 8 Registry and NHANES database. RESULTS A total of 9 617 643 patients with an FPC and 677 430 patients with an SPC were included in the meta-analysis. Patients with a first primary gynaecological cancer and thyroid cancer frequently developed a second primary breast cancer and colorectal cancer. Moreover, those with a first primary head and neck cancer, anal cancer and oesophageal cancer developed a second primary lung cancer more frequently. A second primary lung cancer and prostate cancer was also common among patients with first primary bladder cancer and penile cancer. Patients with second primary bladder cancer accounted for 56% of first primary ureteral cancer patients with SPCs. CONCLUSIONS This study recommends close clinical follow-up, monitoring and appropriate interventions in patients with relevant FPCs for better screening and early diagnosis of SPCs.
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Affiliation(s)
- Xinyu Wang
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Meiyuan Zeng
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xueming Ju
- Department of Utrsound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Anqi Lin
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Chaozheng Zhou
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Junyi Shen
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zaoqu Liu
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing, China
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bufu Tang
- Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Quan Cheng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, P. R. China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
| | - Youyu Wang
- Department of Utrsound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jian Zhang
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Peng Luo
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Chen MH, Epstein SF. Tailored to a Woman's Heart: Gender Cardio-Oncology Across the Lifespan. Curr Cardiol Rep 2023; 25:1461-1474. [PMID: 37819431 PMCID: PMC11034750 DOI: 10.1007/s11886-023-01967-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE OF REVIEW Females outnumber males among long-term cancer survivors, primarily as a result of the prevalence of breast cancer. Late cardiovascular effects of cancer develop over several decades, which for many women, may overlap with reproductive and lifecycle events. Thus, women require longitudinal cardio-oncology care that anticipates and responds to their evolving cardiovascular risk. RECENT FINDINGS Women may experience greater cardiotoxicity from cancer treatments compared to men and a range of treatment-associated hormonal changes that increase cardiometabolic risk. Biological changes at critical life stages, including menarche, pregnancy, and menopause, put female cancer patients and survivors at a unique risk of cardiovascular disease. Women also face distinct psychosocial and physical barriers to accessing cardiovascular care. We describe the need for a lifespan-based approach to cardio-oncology for women. Cardio-oncology care tailored to women should rigorously consider cancer treatment/outcomes and concurrent reproductive/hormonal changes, which collectively shape quality of life and cardiovascular outcomes.
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Affiliation(s)
- Ming Hui Chen
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Boston Children's Hospital/Dana Farber Cancer Institute, Boston, MA, USA.
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.
| | - Sonia F Epstein
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
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3
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Harmeling JX, Woerdeman LAE, Ozdemir E, Schaapveld M, Oldenburg HSA, Janus CPM, Russell NS, Koppert LB, Krul IM, van Leeuwen FE, Mureau MAM. Surgical outcomes following breast reconstruction in patients with and without a history of chest radiotherapy for Hodgkin lymphoma: a multicentre, matched cohort study. Int J Surg 2023; 109:2896-2905. [PMID: 37037583 PMCID: PMC10583922 DOI: 10.1097/js9.0000000000000063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/12/2022] [Indexed: 04/12/2023]
Abstract
BACKGROUND Breast cancer is the most common treatment-related second malignancy among women with previous chest radiotherapy for Hodgkin lymphoma (HL). Little is known about the effects of this kind of radiotherapy on the outcomes of postmastectomy breast reconstruction (BR). This study compared adverse outcomes of BR after HL-related chest radiotherapy to matched controls. METHODS The authors conducted a retrospective, matched cohort study in two expert cancer centres in the Netherlands. BRs after therapeutic or prophylactic mastectomy in HL survivors who received chest radiotherapy were matched with BRs in nonirradiated patients without HL on age at mastectomy date, date of BR, and type of BR. The primary outcome was complication-related BR failure or conversion and secondary outcomes were complication-related re-operation, capsular contracture, major donor-site complications, and complication-related ICU admission. The authors analyzed all outcomes univariably using Fisher's exact tests and the authors assessed reconstruction failure, complication-related re-operation, and capsular contracture with multivariable Cox regression analysis adjusting for confounding and data clustering. RESULTS Seventy BRs in 41 patients who received chest radiotherapy for HL were matched to 121 BRs in 110 nonirradiated patients. Reconstruction failure did not differ between HL survivors (12.9%) and controls (12.4%). The comparison groups showed no differences in number of reoperations, major donor-site complications, or capsular contractures. BR in HL survivors more often let to ICU admission due to complications compared with controls ( P =0.048). CONCLUSIONS We observed no increased risk of adverse outcomes following BR after previous chest radiotherapy for HL. This is important information for counselling these patients and may improve shared decision-making.
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Affiliation(s)
| | | | - Ezgi Ozdemir
- Departments of Plastic and Reconstructive Surgery
| | - Michael Schaapveld
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Cécile P M Janus
- Radiation Oncology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam
| | | | - Linetta B Koppert
- Department of Surgery, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam
| | - Inge M Krul
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Flora E van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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de Vries S, Krul IM, Schaapveld M, Janus CPM, Rademakers SE, Roesink JM, Nijziel MR, Bilgin YM, Aleman BMP, van Leeuwen FE. Risk of male breast cancer after Hodgkin lymphoma. Blood 2023; 142:806-811. [PMID: 37390297 DOI: 10.1182/blood.2023020940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 07/02/2023] Open
Abstract
Female survivors of Hodgkin lymphoma (HL) treated with chest radiotherapy have a strongly increased risk of breast cancer (BC), but the treatment-specific BC risk in male survivors of HL has not been evaluated. We assessed BC risk in a cohort of 3077 male survivors of 5-year HL treated at age ≤51 years in 20 Dutch hospitals between 1965 and 2013. We estimated standardized incidence ratios (SIRs), absolute excess risks per 10 000 person-years, and cumulative BC incidences. After a 20-year median follow-up, we observed 8 cases of male with BC. Male survivors of HL experienced a 23-fold (95% confidence interval [CI], 10.1-46.0) increased BC risk compared with the general population, representing 1.6 (95% CI, 0.7-3.3) excess BC incidences per 10 000 person-years. The 20- and 40-year cumulative BC incidences after HL treatment were 0.1% (95% CI, 0.02-0.3) and 0.7% (95% CI, 0.3-1.4), respectively. Treatment with chest radiotherapy without alkylating chemotherapy yielded a strongly increased SIR (20.7; 95% CI, 2.5-74.8), which was not significantly different for chest radiotherapy and alkylating chemotherapy (41.1; 95% CI, 13.4-96.0). Males treated with chest radiotherapy and anthracyclines had an SIR of 48.1 (95% CI, 13.1-123.1). Two patients died from BC (median follow-up, 4.7 years). To ensure early diagnosis and treatment, clinicians should be alert to BC symptoms in male survivors of HL.
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Affiliation(s)
- Simone de Vries
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Inge M Krul
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Michael Schaapveld
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Cecile P M Janus
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Saskia E Rademakers
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Judith M Roesink
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marten R Nijziel
- Department of Hemato-Oncology, Catharina Cancer Institute, Eindhoven, The Netherlands
| | - Yavuz M Bilgin
- Department of Internal Medicine, Adrz, Goes, The Netherlands
| | - Berthe M P Aleman
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Flora E van Leeuwen
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Swerdlow AJ, Jones ME, Slater SD, Burden ACF, Botha JL, Waugh NR, Morris AD, Gatling W, Gillespie KM, Patterson CC, Schoemaker MJ. Cancer incidence and mortality in 23 000 patients with type 1 diabetes in the UK: Long-term follow-up. Int J Cancer 2023; 153:512-523. [PMID: 37190903 PMCID: PMC10952206 DOI: 10.1002/ijc.34548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/21/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023]
Abstract
Type 2 diabetes is associated with raised risk of several cancers, but for type 1 diabetes risk data are fewer and inconsistent We assembled a cohort of 23 473 UK patients with insulin-treated diabetes diagnosed at ages <30, almost all of whom will have had type 1 diabetes, and for comparison 5058 diagnosed at ages 30 to 49, of whom we estimate two-thirds will have had type 2, and followed them for an average of 30 years for cancer incidence and mortality compared with general population rates. Patients aged <30 at diabetes diagnosis had significantly raised risks only for ovarian (standardised incidence ratio = 1.58; 95% confidence interval 1.16-2.11; P < .01) and vulval (3.55; 1.94-5.96; P < .001) cancers, with greatest risk when diabetes was diagnosed at ages 10-14. Risks of cancer overall (0.89; 0.84-0.95; P < .001) and sites including lung and larynx were significantly diminished. Patients diagnosed with diabetes at ages 30 to 49 had significantly raised risks of liver (1.76;1.08-2.72) and kidney (1.46;1.03-2.00) cancers, and reduced risk of cancer overall (0.89; 0.84-0.95). The raised ovarian and vulval cancer risks in patients with type 1 diabetes, especially with diabetes diagnosed around pubertal ages, suggest possible susceptibility of these organs at puberty to metabolic disruption at diabetes onset. Reduced risk of cancer overall, particularly smoking and alcohol-related sites, might reflect adoption of a healthy lifestyle.
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Affiliation(s)
- Anthony J. Swerdlow
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
- Division of Breast Cancer ResearchThe Institute of Cancer ResearchLondonUK
| | - Michael E. Jones
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | | | | | | | | | | | - Wendy Gatling
- Department of DiabetesPoole Hospital NHS TrustDorsetUK
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Ciccarone M, Cavaceppi P, Tesei C, Brunetti S, Pulsoni A, Annibali O, Gasparoli C, Battistini R, Hohaus S, Pelliccia S, Tafuri A, Cox MC, Cantonetti M, Rigacci L, Abruzzese E. Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin's disease. Front Oncol 2023; 13:1059393. [PMID: 37152067 PMCID: PMC10160490 DOI: 10.3389/fonc.2023.1059393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/27/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Classical Hodgkin Lymphoma (HL) is a lymphoproliferative disease typically diagnosed in the young. The excellent results obtained with current treatment lead to long survival with age-related complications affecting patients' survival and quality of life. One issue affecting HL patients is infertility. This problem can be easily overcome in males with seminal liquid cryopreservation, however, in females it is more complex either in terms of the quality of the cryopreserved material or the patients' age at diagnosis. Moreover, not all chemo- or radio-therapies have the same negative impact on fertility.The main objectives of this study was to collect epidemiological information on HL patients involved in fertility preservation counseling and to analyze the impact of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine), the standard treatment for HL, on ovarian function, hormonal levels and ovarian and uterine tissue morphologies. Patterns of fertility preservation were also reported. Methods Data were obtained from 270 female patients at HL onset who were interested in fertility counseling prior to therapy initiation. Each patient was assessed at HL diagnosis for levels of Anti-Mullerian Hormone (AMH), Follicle Stimulating Hormone (FSH), and 17β-oestradiol (17β-oe), with additional assessments at 6 and 12 months after chemotherapy. Patients were evaluated with ultrasound scans to study the number of ovarian follicles and the degree of uterine thickness at the same timepoints. Results The average patient AMH level showed a statistically significant reduction at 6 months after chemotherapy (p=0.05) and by the 12 month time point returned to near pre-chemotherapy values. FSH and 17β-oe levels did not significantly vary throughout the study period. ABVD chemotherapy was associated with a significant reduction of both ovarian follicles and endometrial thickness at the 6 month time point followed by a recovery at the 12 time point in both ovaries. Different results were observed when patients changed treatment to a more intensive one. Discussion Based on the results from the hormonal measurements and the follicle echography, it appears that the toxic effect of ABVD on fertility is transient, whereas, in contrast, more intensive therapies may potentially be more harmful and long-lasting.
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Affiliation(s)
- Mariavita Ciccarone
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
- Gynecologic Unit , San Carlo di Nancy Hospital, Rome, Italy
| | - Paola Cavaceppi
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
- LabAurelia, Rome, Italy
| | - Cristiano Tesei
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
| | - Stefania Brunetti
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
| | - Alessandro Pulsoni
- Department of Cellular Biotechnology and Haematology, Sapienza University, Rome, Italy
| | - Ombretta Annibali
- UOC Haematology Stem Cell Transplantation, University Campus Bio Medico, Rome, Italy
| | | | - Roberta Battistini
- UOC Ematologia e Trapianti CSE, Azienda Ospedaliera (AO) San Camillo Forlanini, Rome, Italy
| | - Stefan Hohaus
- Policlinico Gemelli Foundation, Catholic University of the Sacred Heart, Rome, Italy
| | - Sabrina Pelliccia
- Haematology Unit, Azienda Ospedaliera‐ Universitaria Sant’Andrea, Rome, Italy
| | - Agostino Tafuri
- Haematology Unit, Azienda Ospedaliera‐ Universitaria Sant’Andrea, Rome, Italy
| | | | | | - Luigi Rigacci
- UOC Ematologia e Trapianti CSE, Azienda Ospedaliera (AO) San Camillo Forlanini, Rome, Italy
| | - Elisabetta Abruzzese
- Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
- *Correspondence: Elisabetta Abruzzese,
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Second malignant neoplasms in lymphomas, secondary lymphomas and lymphomas in metabolic disorders/diseases. Cell Biosci 2022; 12:30. [PMID: 35279210 PMCID: PMC8917635 DOI: 10.1186/s13578-022-00763-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/14/2022] [Indexed: 12/02/2022] Open
Abstract
With inconsistent findings, evidence has been obtained in recent years that metabolic disorders are closely associated with the development of lymphomas. Studies and multiple analyses have been published also indicating that some solid tumor survivors develop a secondary lymphoma, whereas some lymphoma survivors subsequently develop a second malignant neoplasm (SMN), particularly solid tumors. An interaction between the multiple etiologic factors such as genetic factors and late effects of cancer therapy may play an important role contributing to the carcinogenesis in patients with metabolic diseases or with a primary cancer. In this review, we summarize the current knowledge of the multiple etiologic factors for lymphomagenesis, focusing on the SMN in lymphoma, secondary lymphomas in primary cancers, and the lymphomas associated to metabolic disorders/diseases, which have been received less attention previously. Further, we also review the data of coexistence of lymphomas and hepatocellular carcinoma (HCC) in patients with infection of hepatitis C virus and hepatitis B virus.
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8
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Xia C, Qin L, Wang Y, Yao L, Shia B, Wu SY. Risk factors and specific cancer types of second primary malignancies in patients with breast cancer receiving adjuvant radiotherapy: a case-control cohort study based on the SEER database. Am J Cancer Res 2022; 12:2744-2756. [PMID: 35812050 PMCID: PMC9251704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/14/2022] [Indexed: 06/15/2023] Open
Abstract
Patients with breast cancer can survive and live a long, cancer-free life; however, late complications of treatment, such as second primary malignancies (SPMs), have emerged as a competing cause of death and morbidity. We conducted a long-term population-based cohort study to identify the risk factors for SPMs and specific secondary cancer types after various latency periods of irradiated breast cancer. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) for independent risk factors for SPM. We also calculated the HR of each specific cancer type and the latency time to specific SPMs. The risk of SPM was statistically significantly higher in patients with adjuvant RT than in patients without adjuvant RT (adjusted HR [aHR]: 1.105, 95% CI: 1.013-1.206). Compared with the control group, the case group had significantly increased risks of contralateral breast cancer (aHR: 1.268, 95% CI: 1.112-1.445), lung cancer (aHR: 1.218, 95% CI: 1.049-1.565), and urinary system cancer (aHR: 1.702, 95% CI: 1.140-2.543). Adjuvant RT for breast cancer increases the risk of SPM. Contralateral breast cancer, lung cancer, and bladder cancer were significant SPMs after breast RT, although the cumulative risk of SPM was low, at approximately 6, 10, and 13 cancers per 1000 women with irradiated breasts at latency periods of 5, 10, and 15 years, respectively, after breast RT.
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Affiliation(s)
- Chuanxin Xia
- Chinese Academy of International Trade and Economic CooperationDongcheng, Beijing, China
| | - Lei Qin
- School of Statistics, University of International Business and EconomicsBeijing, China
| | - Yinzhi Wang
- School of Statistics, University of International Business and EconomicsBeijing, China
| | - Ling Yao
- Chinese Academy of International Trade and Economic CooperationDongcheng, Beijing, China
| | - Benchang Shia
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic UniversityNew Taipei City, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic UniversityNew Taipei City, Taiwan
| | - Szu-Yuan Wu
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic UniversityNew Taipei City, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic UniversityNew Taipei City, Taiwan
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia UniversityTaichung, Taiwan
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai HospitalYilan, Taiwan
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai HospitalYilan, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia UniversityTaichung, Taiwan
- Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical UniversityTaipei, Taiwan
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9
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Radiation-induced tumors and secondary malignancies following radiotherapy. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp201210017d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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10
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Cahoon EK, Preston D, Zhang R, Vij V, Little MP, Mabuchi K, Drozdovitch V, Chizhov K, Yauseyenka VV, Rozhko AV, Velalkin IV. Breast cancer risk in residents of Belarus exposed to Chernobyl fallout while pregnant or lactating: standardized incidence ratio analysis, 1997 to 2016. Int J Epidemiol 2021; 51:547-554. [PMID: 34687542 DOI: 10.1093/ije/dyab226] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Pregnancy and lactation may constitute radiation-sensitive reproductive periods due to rapid cell proliferation and concentration of radioiodine in the lactating breast. However, there are limited epidemiological data among women exposed to radiation during these periods. METHODS We examined incidence of breast cancer in a cohort of 3214 women who were pregnant and/or lactating within 2 months (26 April to 30 June 1986) of the Chernobyl accident and residing in contaminated regions of Belarus. There were 33 breast cancers identified through linkage with the Belarusian National Cancer Registry. Breast cancer rates among women who were either pregnant and/or lactating were compared with population rates by calculating standardized incidence ratios (SIR) and 95% confidence intervals (CI) adjusting for attained age, oblast, urban/rural residence and calendar year. RESULTS Among women who were lactating, we found a greater than 2-fold increased risk of breast cancer compared with the general population, SIR = 2.49 (95% CI: 1.55, 3.75). In contrast, women who were pregnant were not at increased risk (SIR = 0.84 95% CI: 0.46, 1.38). The SIR was highest in women who were exposed at a younger age and at the earliest time period since the accident, though stratified analyses had limited sample sizes. CONCLUSIONS We found a significantly increased risk of breast cancer among women residing in contaminated areas of Belarus who were lactating at the time of the accident and may have had elevated exposure to radioiodine, when compared with the general population. Studies of breast cancer with individual radiation dose estimates among women exposed during lactation are warranted.
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Affiliation(s)
- Elizabeth K Cahoon
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Rui Zhang
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Vibha Vij
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Mark P Little
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Kiyohiko Mabuchi
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Vladimir Drozdovitch
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Konstantin Chizhov
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Alexander V Rozhko
- Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Belarus
| | - Ilya V Velalkin
- Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Belarus
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11
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Mampunye L, van der Merwe NC, Grant KA, Peeters AV, Torrorey-Sawe R, French DJ, Moremi KE, Kidd M, van Eeden PC, Pienaar FM, Kotze MJ. Pioneering BRCA1/2 Point-Of-Care Testing for Integration of Germline and Tumor Genetics in Breast Cancer Risk Management: A Vision for the Future of Translational Pharmacogenomics. Front Oncol 2021; 11:619817. [PMID: 34660253 PMCID: PMC8513538 DOI: 10.3389/fonc.2021.619817] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Research performed in South African (SA) breast, ovarian and prostate cancer patients resulted in the development of a rapid BRCA point-of-care (POC) assay designed as a time- and cost-effective alternative to laboratory-based technologies currently used for first-tier germline DNA testing. In this study the performance of the new assay was evaluated for use on a portable screening device (ParaDNA), with the long-term goal to enable rollout at POC as an inventive step to meet the World Health Organization’s sustainable development goals for Africa. DNA samples for germline testing were obtained retrospectively from 50 patients with early-stage hormone receptor-positive breast cancer referred for genomic tumor profiling (MammaPrint). Currently, SA patients with the luminal-type breast cancer are not routinely selected for BRCA1/2 testing as is the case for triple-negative disease. An initial evaluation involved the use of multiple control samples representing each of the pathogenic founder/recurrent variants included in the BRCA 1.0 POC Research Assay. Comparison with a validated laboratory-based first-tier real-time polymerase chain reaction (PCR) assay demonstrated 100% concordance. Clinical utility was evident in five patients with the founder BRCA2 c.7934delG variant, identified at the 10% (5/50) threshold considered cost-effective for BRCA1/2 testing. BRCA2 c.7934delG carrier status was associated with a significantly younger age (p=0.03) at diagnosis of breast cancer compared to non-carriers. In three of the BRCA2 c.7934delG carriers a high-risk MammaPrint 70-gene profile was noted, indicating a significantly increased risk for both secondary cancers and breast cancer recurrence. Initiating germline DNA testing at the POC for clinical interpretation early in the treatment planning process, will increase access to the most common pathogenic BRCA1/2 variants identified in SA and reduce loss to follow-up for timely gene-targeted risk reduction intervention. The ease of using cheek swabs/saliva in future for result generation within approximately one hour assay time, coupled with low cost and a high BRCA1/2 founder variant detection rate, will improve access to genomic medicine in Africa. Application of translational pharmacogenomics across ethnic groups, irrespective of age, family history, tumor subtype or recurrence risk profile, is imperative to sustainably implement preventative healthcare and improve clinical outcome in resource-constrained clinical settings.
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Affiliation(s)
- Lwando Mampunye
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Nerina C van der Merwe
- Division of Human Genetics, National Health Laboratory Service, Universitas Hospital, Bloemfontein, South Africa.,Division of Human Genetics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Kathleen A Grant
- Department of Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Armand V Peeters
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rispah Torrorey-Sawe
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Immunology Department, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - David J French
- Division of Health Science and Innovation, LGC Limited, Teddington, United Kingdom
| | - Kelebogile E Moremi
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Martin Kidd
- Centre for Statistical Consultation, University of Stellenbosch, Stellenbosch, South Africa
| | | | | | - Maritha J Kotze
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Division of Chemical Pathology, National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
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12
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Mellemkjær L, Eibye S, Albieri V, Kjær SK, Boice JD. Pregnancy-associated cancer and the risk of second primary cancer. Cancer Causes Control 2021; 33:63-71. [PMID: 34643832 DOI: 10.1007/s10552-021-01500-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Hormonal changes related to pregnancy and lactation among women treated for cancer might influence the risk of second primary cancer. We investigated whether pregnancy near the time of breast cancer, Hodgkin lymphoma or other cancer diagnoses is associated with increased risk of developing a new primary cancer. METHODS Women born after 1 April 1935 diagnosed with cancer at ages 15-44 years during 1968-2006 were identified in the Danish Cancer Registry. Information about pregnancies from various nationwide registers was used to identify women with a pregnancy-associated cancer defined as a cancer diagnosed 6 or fewer months before the pregnancy, during the pregnancy or up to 1 year after the pregnancy. Second primary cancers were ascertained through 2013, and hazard ratios (HRs) were calculated using Cox regression models adjusted for age, calendar-period and number of pregnancies with the reference defined as cancer not associated with a pregnancy. RESULTS We identified 2,974 women with pregnancy-associated cancer and 31,970 women who were not pregnant near the time of their cancer diagnosis. There was no association between pregnancy-associated cancer and a second cancer (HR 0.91; 95% CI 0.79-1.05). Among 680 women with either breast cancer or Hodgkin lymphoma associated with pregnancy, a HR of 1.16 (95% CI 0.87-1.56) for second breast cancer was observed based on 48 cases. CONCLUSION While hormonal changes might stimulate development of specific cancers, in particular breast cancer, it is reassuring that risk of breast and other second cancers was not related to pregnancy near the time of a first primary cancer diagnosis.
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Affiliation(s)
- Lene Mellemkjær
- Unit of Virus Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Simone Eibye
- Department of Oncology and Radiation Biology, Rigshospitalet University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Vanna Albieri
- Unit of Statistics and Data Analyses, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjær
- Unit of Virus Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - John D Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA.,Division of Epidemiology, Department of Medicine, Vanderbilt University, Nashville, TN, USA
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13
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Mulder RL, Hudson MM, Bhatia S, Landier W, Levitt G, Constine LS, Wallace WH, van Leeuwen FE, Ronckers CM, Henderson TO, Moskowitz CS, Friedman DN, Ng AK, Jenkinson HC, Demoor-Goldschmidt C, Skinner R, Kremer LC, Oeffinger KC. Updated Breast Cancer Surveillance Recommendations for Female Survivors of Childhood, Adolescent, and Young Adult Cancer From the International Guideline Harmonization Group. J Clin Oncol 2020; 38:4194-4207. [PMID: 33078972 PMCID: PMC7723685 DOI: 10.1200/jco.20.00562] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 01/02/2023] Open
Abstract
PURPOSE As new evidence is available, the International Late Effects of Childhood Cancer Guideline Harmonization Group has updated breast cancer surveillance recommendations for female survivors of childhood, adolescent, and young adult cancer. METHODS We used evidence-based methods to apply new knowledge in refining the international harmonized recommendations developed in 2013. The guideline panel updated the systematic literature review, developed evidence summaries, appraised the evidence, and updated recommendations on the basis of evidence, clinical judgement, and consideration of benefits versus the harms of the surveillance interventions while attaining flexibility in implementation across different health care systems. The GRADE Evidence-to-Decision framework was used to translate evidence to recommendations. A survivor information form was developed to counsel survivors about the potential harms and benefits of surveillance. RESULTS The literature update identified new study findings related to the effects of prescribed moderate-dose chest radiation (10 to 19 Gy), radiation dose-volume, anthracyclines and alkylating agents in non-chest irradiated survivors, and the effects of ovarian function on breast cancer risk. Moreover, new data from prospective investigations were available regarding the performance metrics of mammography and magnetic resonance imaging among survivors of Hodgkin lymphoma. Modified recommendations include the performance of mammography and breast magnetic resonance imaging for survivors treated with 10 Gy or greater chest radiation (strong recommendation) and upper abdominal radiation exposing breast tissue at a young age (moderate recommendation) at least annually up to age 60 years. As a result of inconsistent evidence, no recommendation could be formulated for routine breast cancer surveillance for survivors treated with any type of anthracyclines in the absence of chest radiation. CONCLUSION The newly identified evidence prompted significant change to the recommendations formulated in 2013 related to moderate-dose chest radiation and anthracycline exposure as well as breast cancer surveillance modality.
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Affiliation(s)
- Renée L. Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Melissa M. Hudson
- Departments of Epidemiology and Cancer Control, and Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship and Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Wendy Landier
- Institute for Cancer Outcomes and Survivorship and Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Gill Levitt
- Department of Oncology/Haematology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Louis S. Constine
- Departments of Radiation Oncology and Pediatrics, University of Rochester Medical Center, Rochester, NY
| | - W. Hamish Wallace
- Department of Paediatric Oncology, Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | - Flora E. van Leeuwen
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Cécile M. Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Institute for Biostatistics and Registry Research, Medical University Brandenburg, Theodor Fontane, Neuruppin, Germany
| | - Tara O. Henderson
- Department of Pediatrics, University of Chicago Pritzker School of Medicine, Chicago, IL
| | - Chaya S. Moskowitz
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Danielle N. Friedman
- Departments of Pediatrics and Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Helen C. Jenkinson
- Department of Paediatric Oncology, Birmingham Children’s Hospital, NHS Foundation Trust, Birmingham, United Kingdom
| | - Charlotte Demoor-Goldschmidt
- Centre for Research in Epidemiology and Population Health, Cancer and Radiation team, University of Paris-Sud, Villejuif, France
- Department of Pediatric and Adolescent Hematology/Oncology, CHU Angers, Angers, France
| | - Roderick Skinner
- Department of Paediatric and Adolescent Haematology/Oncology, Great North Children’s Hospital and Newcastle University Centre for Cancer, Newcastle upon Tyne, United Kingdom
| | - Leontien C.M. Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pediatric Oncology, Emma Children’s Hospital, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
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14
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Hawkins M, Bhatia S, Henderson TO, Nathan PC, Yan A, Teepen JC, Morton LM. Subsequent Primary Neoplasms: Risks, Risk Factors, Surveillance, and Future Research. Pediatr Clin North Am 2020; 67:1135-1154. [PMID: 33131538 DOI: 10.1016/j.pcl.2020.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The authors' objective is to provide a brief update on recent advances in knowledge relating to subsequent primary neoplasms developing in survivors of childhood cancer. This includes a summary of established large-scale cohorts, risks reported, and contrasts with results from recently established large-scale cohorts of survivors of adolescent and young adult cancer. Recent evidence is summarized concerning the role of radiotherapy and chemotherapy for childhood cancer and survivor genomics in determining the risk of subsequent primary neoplasms. Progress with surveillance, screening, and clinical follow-up guidelines is addressed. Finally, priorities for future research are outlined.
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Affiliation(s)
- Michael Hawkins
- Epidemiology & Director of Centre, Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Robert Aitken Building, Birmingham B15 2TY, UK.
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Paul C Nathan
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Adam Yan
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Jop C Teepen
- Princess Maxima Centre for Paediatric Oncology, Utrecht, The Netherlands
| | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, USA
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15
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Bakkach J, Pellegrino B, Elghazawy H, Novosad O, Agrawal S, Bennani Mechita M. Current overview and special considerations for second breast cancer in Hodgkin lymphoma survivors. Crit Rev Oncol Hematol 2020; 157:103175. [PMID: 33321295 DOI: 10.1016/j.critrevonc.2020.103175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 06/28/2020] [Accepted: 11/05/2020] [Indexed: 12/15/2022] Open
Abstract
Second breast cancer (SBC) is the most common solid cancer among Hodgkin Lymphoma (HL) female survivors. We reviewed the related modifying risk factors, radiation-induced carcinogenesis, tumors characteristics, management specificities, prevention and surveillance modalities based on current evidence. The risk of developing SBC may be influenced essentially by the age at HL treatment, follow-up latency, dose of irradiation received and the extent of irradiated field. SBCs generally develop at younger age, they are often bilateral, and exhibit more aggressive biological features and worse prognosis. No firm answer about the benefits of breast surveillance is provided by literature, but compelling evidence tends toward a clinical benefit in early detection. Increasing awareness among health providers' care and current survivors as well as the implementation of screening measures is crucial. Great efforts are ongoing in individualizing treatment strategies for future HL patients and response-adapted approaches are holding promise in prevention of these second malignancies.
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Affiliation(s)
- Joaira Bakkach
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, Abdelmalek Essaâdi University, Morocco.
| | | | - Hagar Elghazawy
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Egypt.
| | - Olga Novosad
- Onco-Hematology Department, National Cancer Institute of the MPH Ukraine, Kiev, Ukraine.
| | - Sanjit Agrawal
- Department of Breast Oncosurgery, Tata Medical Center, Kolkata, West Bengal, India.
| | - Mohcine Bennani Mechita
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, Abdelmalek Essaâdi University, Morocco.
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16
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Bansal GJ, Purchase D, Wray M. Routine use of both mammography and MRI surveillance in patients with previous 'mammogram occult' breast cancer: experience from a tertiary centre. Postgrad Med J 2020; 98:18-23. [PMID: 33087534 DOI: 10.1136/postgradmedj-2020-138571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/15/2020] [Accepted: 09/24/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND To evaluate the role of combined MRI and mammogram follow-up in patients with previous 'mammographically occult' breast cancer. METHODS Between 2011 and 2016, examinations of all patients undergoing routine surveillance following previous 'mammogram occult' breast cancer were evaluated. Patients had both MRI and mammograms on the same day with an interval of 12-18 months between consecutive pairs. Total number of recalls on both imaging modalities and the outcome of those recalls was recorded. There were six median examinations per patient. RESULTS There were a total of 325 examinations of 54 patients. There were 96 mammograms/MRI pairs and 87 lone MRI and 46 lone mammograms. There were a total of 26 recalls in 21 patients. MRI had specificity (95% CI) of 89.99 (85.67 to 93.11) compared to mammograms 96.27 (92.53 to 98.25). The diagnostic OR with 95% CI was 19.40 (3.70 to 101.57) vs 6.72 (1.43 to 31.58) of mammograms and MRI, respectively. Three of seven cancers presented symptomatically. CONCLUSIONS MRI surveillance leads to higher recalls and false positives compared to mammograms in this specific subgroup of high-risk patients. Large proportion of cancers presented symptomatically, stressing the importance of remaining vigilant of breast symptoms despite imaging surveillance.
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Affiliation(s)
- Gaurav J Bansal
- The Breast Centre, Cardiff and Vale University Health Board, Cardiff, UK
| | - David Purchase
- The Breast Centre, Cardiff and Vale University Health Board, Cardiff, UK
| | - Matthew Wray
- The Breast Centre, Cardiff and Vale University Health Board, Cardiff, UK
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17
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Applegate KE, Rühm W, Wojcik A, Bourguignon M, Brenner A, Hamasaki K, Imai T, Imaizumi M, Imaoka T, Kakinuma S, Kamada T, Nishimura N, Okonogi N, Ozasa K, Rübe CE, Sadakane A, Sakata R, Shimada Y, Yoshida K, Bouffler S. Individual response of humans to ionising radiation: governing factors and importance for radiological protection. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2020; 59:185-209. [PMID: 32146555 DOI: 10.1007/s00411-020-00837-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 02/26/2020] [Indexed: 05/23/2023]
Abstract
Tissue reactions and stochastic effects after exposure to ionising radiation are variable between individuals but the factors and mechanisms governing individual responses are not well understood. Individual responses can be measured at different levels of biological organization and using different endpoints following varying doses of radiation, including: cancers, non-cancer diseases and mortality in the whole organism; normal tissue reactions after exposures; and, cellular endpoints such as chromosomal damage and molecular alterations. There is no doubt that many factors influence the responses of people to radiation to different degrees. In addition to the obvious general factors of radiation quality, dose, dose rate and the tissue (sub)volume irradiated, recognized and potential determining factors include age, sex, life style (e.g., smoking, diet, possibly body mass index), environmental factors, genetics and epigenetics, stochastic distribution of cellular events, and systemic comorbidities such as diabetes or viral infections. Genetic factors are commonly thought to be a substantial contributor to individual response to radiation. Apart from a small number of rare monogenic diseases such as ataxia telangiectasia, the inheritance of an abnormally responsive phenotype among a population of healthy individuals does not follow a classical Mendelian inheritance pattern. Rather it is considered to be a multi-factorial, complex trait.
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Affiliation(s)
| | - W Rühm
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Radiation Medicine, Neuherberg, Germany
| | - A Wojcik
- Centre for Radiation Protection Research, MBW Department, Stockholm University, Stockholm, Sweden
| | - M Bourguignon
- Department of Biophysics and Nuclear Medicine, University of Paris Saclay (UVSQ), Verseilles, France
| | - A Brenner
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - K Hamasaki
- Department of Molecular Biosciences, Radiation Effects Research Foundation, Hiroshima, Japan
| | - T Imai
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - M Imaizumi
- Department of Nagasaki Clinical Studies, Radiation Effects Research Foundation, Nagasaki, Japan
| | - T Imaoka
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan
| | - S Kakinuma
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan
| | - T Kamada
- QST Hospital, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan
| | - N Nishimura
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan
| | - N Okonogi
- QST Hospital, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan
| | - K Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - C E Rübe
- Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar, Germany
| | - A Sadakane
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - R Sakata
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Y Shimada
- National Institute for Quantum and Radiological Science and Technology, Chiba, Japan
- Institute for Environmental Sciences, Aomori, Japan
| | - K Yoshida
- Immunology Laboratory, Department of Molecular Biosciences, Radiation Effects Research Foundation, Hiroshima, Japan
| | - S Bouffler
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilto, Didcot, UK
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18
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Opstal-van Winden AWJ, de Haan HG, Hauptmann M, Schmidt MK, Broeks A, Russell NS, Janus CPM, Krol ADG, van der Baan FH, De Bruin ML, van Eggermond AM, Dennis J, Anton-Culver H, Haiman CA, Sawyer EJ, Cox A, Devilee P, Hooning MJ, Peto J, Couch FJ, Pharoah P, Orr N, Easton DF, Aleman BMP, Strong LC, Bhatia S, Cooke R, Robison LL, Swerdlow AJ, van Leeuwen FE. Genetic susceptibility to radiation-induced breast cancer after Hodgkin lymphoma. Blood 2019; 133:1130-1139. [PMID: 30573632 PMCID: PMC6405334 DOI: 10.1182/blood-2018-07-862607] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 12/12/2018] [Indexed: 12/11/2022] Open
Abstract
Female Hodgkin lymphoma (HL) patients treated with chest radiotherapy (RT) have a very high risk of breast cancer. The contribution of genetic factors to this risk is unclear. We therefore examined 211 155 germline single-nucleotide polymorphisms (SNPs) for gene-radiation interaction on breast cancer risk in a case-only analysis including 327 breast cancer patients after chest RT for HL and 4671 first primary breast cancer patients. Nine SNPs showed statistically significant interaction with RT on breast cancer risk (false discovery rate, <20%), of which 1 SNP in the PVT1 oncogene attained the Bonferroni threshold for statistical significance. A polygenic risk score (PRS) composed of these SNPs (RT-interaction-PRS) and a previously published breast cancer PRS (BC-PRS) derived in the general population were evaluated in a case-control analysis comprising the 327 chest-irradiated HL patients with breast cancer and 491 chest-irradiated HL patients without breast cancer. Patients in the highest tertile of the RT-interaction-PRS had a 1.6-fold higher breast cancer risk than those in the lowest tertile. Remarkably, we observed a fourfold increased RT-induced breast cancer risk in the highest compared with the lowest decile of the BC-PRS. On a continuous scale, breast cancer risk increased 1.4-fold per standard deviation of the BC-PRS, similar to the effect size found in the general population. This study demonstrates that genetic factors influence breast cancer risk after chest RT for HL. Given the high absolute breast cancer risk in radiation-exposed women, these results can have important implications for the management of current HL survivors and future patients.
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Affiliation(s)
| | | | | | - Marjanka K Schmidt
- Department of Epidemiology and Biostatistics
- Division of Molecular Pathology
| | - Annegien Broeks
- Division of Molecular Pathology, Core Facility Molecular Pathology and Biobanking, and
| | - Nicola S Russell
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Cécile P M Janus
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Augustinus D G Krol
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Marie L De Bruin
- Department of Epidemiology and Biostatistics
- Copenhagen Centre for Regulatory Science (CORS), University of Copenhagen, Copenhagen, Denmark
| | | | - Joe Dennis
- Center for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California Irvine, Irvine, CA
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Elinor J Sawyer
- Innovation Hub, Guy's Cancer Centre, King's College London, London, United Kingdom
| | - Angela Cox
- Sheffield Cancer Research, Department of Oncology, University of Sheffield, Sheffield, United Kingdom
| | - Peter Devilee
- Department of Pathology and
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Maartje J Hooning
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Julian Peto
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Paul Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, and
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Nick Orr
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Douglas F Easton
- Center for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Oncology, and
| | - Berthe M P Aleman
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL
| | - Rosie Cooke
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN; and
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
- Division of Breast Cancer Research, The Institute of Cancer Research, London, United Kingdom
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19
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Differential effect of parity on rat mammary carcinogenesis after pre- or post-pubertal exposure to radiation. Sci Rep 2018; 8:14325. [PMID: 30254198 PMCID: PMC6156598 DOI: 10.1038/s41598-018-32406-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 09/03/2018] [Indexed: 01/28/2023] Open
Abstract
Radiation exposure during the peri-pubertal period is a proven risk factor for breast cancer, whereas parity is an established protective factor. The present study investigated whether parity imposes differential protective effects against radiation-induced rat mammary carcinoma depending on the age at exposure. Pre- and post-pubertal female rats, irradiated or left unirradiated, were mated and allowed to nurse until weaning or left unmated. Appearance of mammary tumors was monitored, and serum concentrations of estradiol and progesterone were measured following weaning. Carcinomas were evaluated by immunohistochemistry for estrogen receptor, progesterone receptor, and the cell proliferation marker Ki-67. Parity reduced the risk of carcinoma in unirradiated and pre-pubertally irradiated rats but not post-pubertally irradiated rats. Although radiation exposure increased serum progesterone level, parity after pre-pubertal exposure significantly decreased the elevated progesterone to a normal level, reflecting a protective effect. Moreover, parity significantly decreased the proportion of hormone receptor–positive carcinomas after pre-pubertal exposure. Parity was also related to the observed positive association between progesterone receptor and Ki-67 indices in cancer tissue, implying progesterone receptor–dependent cell proliferation. Thus, parity protects against radiation-induced rat mammary carcinogenesis depending on the age at exposure; the mechanisms may involve changes in hormone levels and cancer tissue.
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20
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Brenner AV, Preston DL, Sakata R, Sugiyama H, Berrington de Gonzalez A, French B, Utada M, Cahoon EK, Sadakane A, Ozasa K, Grant EJ, Mabuchi K. Incidence of Breast Cancer in the Life Span Study of Atomic Bomb Survivors: 1958-2009. Radiat Res 2018; 190:433-444. [PMID: 30044713 DOI: 10.1667/rr15015.1] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The importance of reproductive history in breast tissue development and etiology of sporadic breast cancer in females is well established. However, there is limited evidence of factors, other than age, that modify risk of radiation-related breast cancer. In this study, we evaluated breast cancer incidence in the Life Span Study cohort of atomic bomb survivors, adding 11 years of follow-up and incorporating reproductive history data. We used Poisson regression models to describe radiation risks and modifying effects of age and reproductive factors. Among 62,534 females, we identified 1,470 breast cancers between 1958 and 2009. Of 397 new cases diagnosed since 1998, 75% were exposed before age 20. We found a strong linear dose response with excess relative risk (ERR) of 1.12 per Gy [95% confidence interval (CI): 0.73 to 1.59] for females at age 70 after exposure at age 30. The ERR decreased with increasing attained age ( P = 0.007) while excess absolute rate (EAR) increased with attained age up to age 70 ( P < 0.001). Age at menarche was a strong modifier of the radiation effect: for a given dose, both the ERR and EAR decreased with increasing age at menarche ( P = 0.007 and P < 0.001). Also, independently, age-at-exposure effects on ERR and EAR differed before and after menarche ( P = 0.043 and P = 0.015, respectively, relative to log-linear trends), with highest risks for exposures around menarche. Despite the small number of male breast cancers (n = 10), the data continue to suggest a dose response (ERR per Gy = 5.7; 95% CI: 0.3 to 30.8; P = 0.018). Persistently increased risk of female breast cancer after radiation exposure and its modification pattern suggests heightened breast sensitivity during puberty.
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Affiliation(s)
- Alina V Brenner
- a Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | | | - Ritsu Sakata
- a Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Hiromi Sugiyama
- a Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Amy Berrington de Gonzalez
- c Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Benjamin French
- a Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Mai Utada
- a Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Elizabeth K Cahoon
- c Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Atsuko Sadakane
- a Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Kotaro Ozasa
- a Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Eric J Grant
- a Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Kiyohiko Mabuchi
- c Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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Turcotte LM, Neglia JP, Reulen RC, Ronckers CM, van Leeuwen FE, Morton LM, Hodgson DC, Yasui Y, Oeffinger KC, Henderson TO. Risk, Risk Factors, and Surveillance of Subsequent Malignant Neoplasms in Survivors of Childhood Cancer: A Review. J Clin Oncol 2018; 36:2145-2152. [PMID: 29874133 DOI: 10.1200/jco.2017.76.7764] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Subsequent malignant neoplasms (SMNs) in childhood cancer survivors cause substantial morbidity and mortality. This review summarizes recent literature on SMN epidemiology, risk factors, surveillance, and interventions. Survivors of childhood cancer experience long-term increased SMN risk compared with the general population, with a greater than twofold increased solid tumor risk extending beyond age 40 years. There is a dose-dependent increased risk for solid tumors after radiotherapy, with the highest risks for tumors occurring in or near the treatment field (eg, greater than fivefold increased risk for breast, brain, thyroid, skin, bone, and soft tissue malignancies). Alkylating and anthracycline chemotherapies increase the risk for development of several solid malignancies in addition to acute leukemia/myelodysplasia, and these risks may be modified by other patient characteristics, such as age at exposure and, potentially, inherited genetic susceptibility. Strategies for identifying survivors at risk and initiating long-term surveillance have improved and interventions are underway to improve knowledge about late-treatment effects among survivors and caregivers. Better understanding of treatment-related risk factors and genetic susceptibility holds promise for refining surveillance strategies and, ultimately, upfront cancer therapies.
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Affiliation(s)
- Lucie M Turcotte
- Lucie M. Turcotte, Joseph P. Neglia, University of Minnesota Medical School, Minneapolis, MN; Raoul C. Reulen, University of Birmingham, Birmingham, UK; Cecile M. Ronckers, Dutch Childhood Oncology Group Long-term Effects After Childhood Cancer Consortium, The Hague; Flora E. van Leeuwen, Netherlands Cancer Institute, Amsterdam, the Netherlands; Lindsay M. Morton, National Institutes of Health, Bethesda, MD; David C. Hodgson, University of Toronto, Toronto, Canada; Yutaka Yasui, St Jude Children's Research Hospital, Memphis, TN; Kevin C. Oeffinger, Duke University, Durham, NC; and Tara O. Henderson, University of Chicago Comer Children's Hospital, Chicago, IL
| | - Joseph P Neglia
- Lucie M. Turcotte, Joseph P. Neglia, University of Minnesota Medical School, Minneapolis, MN; Raoul C. Reulen, University of Birmingham, Birmingham, UK; Cecile M. Ronckers, Dutch Childhood Oncology Group Long-term Effects After Childhood Cancer Consortium, The Hague; Flora E. van Leeuwen, Netherlands Cancer Institute, Amsterdam, the Netherlands; Lindsay M. Morton, National Institutes of Health, Bethesda, MD; David C. Hodgson, University of Toronto, Toronto, Canada; Yutaka Yasui, St Jude Children's Research Hospital, Memphis, TN; Kevin C. Oeffinger, Duke University, Durham, NC; and Tara O. Henderson, University of Chicago Comer Children's Hospital, Chicago, IL
| | - Raoul C Reulen
- Lucie M. Turcotte, Joseph P. Neglia, University of Minnesota Medical School, Minneapolis, MN; Raoul C. Reulen, University of Birmingham, Birmingham, UK; Cecile M. Ronckers, Dutch Childhood Oncology Group Long-term Effects After Childhood Cancer Consortium, The Hague; Flora E. van Leeuwen, Netherlands Cancer Institute, Amsterdam, the Netherlands; Lindsay M. Morton, National Institutes of Health, Bethesda, MD; David C. Hodgson, University of Toronto, Toronto, Canada; Yutaka Yasui, St Jude Children's Research Hospital, Memphis, TN; Kevin C. Oeffinger, Duke University, Durham, NC; and Tara O. Henderson, University of Chicago Comer Children's Hospital, Chicago, IL
| | - Cecile M Ronckers
- Lucie M. Turcotte, Joseph P. Neglia, University of Minnesota Medical School, Minneapolis, MN; Raoul C. Reulen, University of Birmingham, Birmingham, UK; Cecile M. Ronckers, Dutch Childhood Oncology Group Long-term Effects After Childhood Cancer Consortium, The Hague; Flora E. van Leeuwen, Netherlands Cancer Institute, Amsterdam, the Netherlands; Lindsay M. Morton, National Institutes of Health, Bethesda, MD; David C. Hodgson, University of Toronto, Toronto, Canada; Yutaka Yasui, St Jude Children's Research Hospital, Memphis, TN; Kevin C. Oeffinger, Duke University, Durham, NC; and Tara O. Henderson, University of Chicago Comer Children's Hospital, Chicago, IL
| | - Flora E van Leeuwen
- Lucie M. Turcotte, Joseph P. Neglia, University of Minnesota Medical School, Minneapolis, MN; Raoul C. Reulen, University of Birmingham, Birmingham, UK; Cecile M. Ronckers, Dutch Childhood Oncology Group Long-term Effects After Childhood Cancer Consortium, The Hague; Flora E. van Leeuwen, Netherlands Cancer Institute, Amsterdam, the Netherlands; Lindsay M. Morton, National Institutes of Health, Bethesda, MD; David C. Hodgson, University of Toronto, Toronto, Canada; Yutaka Yasui, St Jude Children's Research Hospital, Memphis, TN; Kevin C. Oeffinger, Duke University, Durham, NC; and Tara O. Henderson, University of Chicago Comer Children's Hospital, Chicago, IL
| | - Lindsay M Morton
- Lucie M. Turcotte, Joseph P. Neglia, University of Minnesota Medical School, Minneapolis, MN; Raoul C. Reulen, University of Birmingham, Birmingham, UK; Cecile M. Ronckers, Dutch Childhood Oncology Group Long-term Effects After Childhood Cancer Consortium, The Hague; Flora E. van Leeuwen, Netherlands Cancer Institute, Amsterdam, the Netherlands; Lindsay M. Morton, National Institutes of Health, Bethesda, MD; David C. Hodgson, University of Toronto, Toronto, Canada; Yutaka Yasui, St Jude Children's Research Hospital, Memphis, TN; Kevin C. Oeffinger, Duke University, Durham, NC; and Tara O. Henderson, University of Chicago Comer Children's Hospital, Chicago, IL
| | - David C Hodgson
- Lucie M. Turcotte, Joseph P. Neglia, University of Minnesota Medical School, Minneapolis, MN; Raoul C. Reulen, University of Birmingham, Birmingham, UK; Cecile M. Ronckers, Dutch Childhood Oncology Group Long-term Effects After Childhood Cancer Consortium, The Hague; Flora E. van Leeuwen, Netherlands Cancer Institute, Amsterdam, the Netherlands; Lindsay M. Morton, National Institutes of Health, Bethesda, MD; David C. Hodgson, University of Toronto, Toronto, Canada; Yutaka Yasui, St Jude Children's Research Hospital, Memphis, TN; Kevin C. Oeffinger, Duke University, Durham, NC; and Tara O. Henderson, University of Chicago Comer Children's Hospital, Chicago, IL
| | - Yutaka Yasui
- Lucie M. Turcotte, Joseph P. Neglia, University of Minnesota Medical School, Minneapolis, MN; Raoul C. Reulen, University of Birmingham, Birmingham, UK; Cecile M. Ronckers, Dutch Childhood Oncology Group Long-term Effects After Childhood Cancer Consortium, The Hague; Flora E. van Leeuwen, Netherlands Cancer Institute, Amsterdam, the Netherlands; Lindsay M. Morton, National Institutes of Health, Bethesda, MD; David C. Hodgson, University of Toronto, Toronto, Canada; Yutaka Yasui, St Jude Children's Research Hospital, Memphis, TN; Kevin C. Oeffinger, Duke University, Durham, NC; and Tara O. Henderson, University of Chicago Comer Children's Hospital, Chicago, IL
| | - Kevin C Oeffinger
- Lucie M. Turcotte, Joseph P. Neglia, University of Minnesota Medical School, Minneapolis, MN; Raoul C. Reulen, University of Birmingham, Birmingham, UK; Cecile M. Ronckers, Dutch Childhood Oncology Group Long-term Effects After Childhood Cancer Consortium, The Hague; Flora E. van Leeuwen, Netherlands Cancer Institute, Amsterdam, the Netherlands; Lindsay M. Morton, National Institutes of Health, Bethesda, MD; David C. Hodgson, University of Toronto, Toronto, Canada; Yutaka Yasui, St Jude Children's Research Hospital, Memphis, TN; Kevin C. Oeffinger, Duke University, Durham, NC; and Tara O. Henderson, University of Chicago Comer Children's Hospital, Chicago, IL
| | - Tara O Henderson
- Lucie M. Turcotte, Joseph P. Neglia, University of Minnesota Medical School, Minneapolis, MN; Raoul C. Reulen, University of Birmingham, Birmingham, UK; Cecile M. Ronckers, Dutch Childhood Oncology Group Long-term Effects After Childhood Cancer Consortium, The Hague; Flora E. van Leeuwen, Netherlands Cancer Institute, Amsterdam, the Netherlands; Lindsay M. Morton, National Institutes of Health, Bethesda, MD; David C. Hodgson, University of Toronto, Toronto, Canada; Yutaka Yasui, St Jude Children's Research Hospital, Memphis, TN; Kevin C. Oeffinger, Duke University, Durham, NC; and Tara O. Henderson, University of Chicago Comer Children's Hospital, Chicago, IL
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Dracham CB, Shankar A, Madan R. Radiation induced secondary malignancies: a review article. Radiat Oncol J 2018; 36:85-94. [PMID: 29983028 PMCID: PMC6074073 DOI: 10.3857/roj.2018.00290] [Citation(s) in RCA: 149] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 06/27/2018] [Accepted: 06/27/2018] [Indexed: 12/31/2022] Open
Abstract
Radiation-induced second malignancies (RISM) is one of the important late side effects of radiation therapy and has an impact on optimal treatment decision-making. Many factors contribute to the development of RISM such as age at radiation, dose and volume of irradiated area, type of irradiated organ and tissue, radiation technique and individual and family history of cancer. Exact mechanism of RISM is unknown. But nowadays, it is a growing concern in oncology because of the increased number of cancer survivors and efforts are being made to prevent or decrease the incidence of RISM. The primary search for articles was carried via Google Scholar and PubMed with keywords included 'radiation induced malignancies, second malignancies, and chemotherapy induced malignancies'. Additional papers were found through references from relevant articles. In this review article, we have discussed about the pathogenesis, factors contributing to RISM, screening and prevention strategies of RISM.
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Affiliation(s)
| | - Abhash Shankar
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
| | - Renu Madan
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
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Kumar V, Garg M, Chandra AB, Mayorga VS, Ahmed S, Ailawadhi S. Trends in the Risks of Secondary Cancers in Patients With Hodgkin Lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:576-589.e1. [PMID: 29934060 DOI: 10.1016/j.clml.2018.05.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/08/2018] [Accepted: 05/21/2018] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The present study analyzed the trends in secondary cancer (SC) risks among Hodgkin lymphoma (HL) patients in the United States. MATERIALS AND METHODS Patients with HL diagnosed from 1973 to 2014 were identified from the Surveillance, Epidemiology, and End Results database. We compared the risk of SCs in HL patients relative to the risk in the US general population across 3 periods: 1973 to 1986, 1987 to 2000, and 2001 to 2014 to study the effect of treatment practices on the development of SCs. RESULTS In a follow-up study of 23,864 HL survivors for 284,730 person-years, 3260 SCs were diagnosed with a standardized incidence ratio (SIR) of 1.97 (95% confidence interval [CI], 1.9-2.04). A statistically significant decrease was found in the overall SIRs of SCs diagnosed in HL patients from 1987 to 2000 (SIR, 1.82; 95% CI, 1.72-1.93) and from 2001 to 2014 (SIR, 1.66; 95% CI, 1.51-1.82) relative to patients with SCs diagnosed from 1973 to 1986 (SIR, 2.24; 95% CI, 2.13-2.35). The decline in the overall SIR mostly resulted from declines in digestive tract and breast cancers. The SIRs of most other solid tumors and hematologic malignancies did not decrease. After adjusting for age, gender, and race, patients with a diagnosis from 1973 to 1986 had a 12% greater risk of developing SCs (hazard ratio, 1.12; 95% CI, 1.03-1.23; P = .01) compared with the patients with a diagnosis from 1987 to 2000. CONCLUSION Although the overall risk of SCs in patients with HL declined after modifications in HL treatment, the risk did not change significantly at most individual sites. Thus, close follow-up with active surveillance for SCs is crucial for long-term survivors of HL.
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Affiliation(s)
- Vivek Kumar
- Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA
| | - Mohit Garg
- Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA; Maimonides Medical Center, Brooklyn, NY
| | - Abhinav B Chandra
- Department of Hematology and Oncology, Yuma Regional Medical Center Cancer Center, Yuma, AZ
| | | | - Salman Ahmed
- Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL
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Dixon SB, Bjornard KL, Alberts NM, Armstrong GT, Brinkman TM, Chemaitilly W, Ehrhardt MJ, Fernandez-Pineda I, Force LM, Gibson TM, Green DM, Howell CR, Kaste SC, Kirchhoff A, Klosky JL, Krull KR, Lucas JT, Mulrooney DA, Ness KK, Wilson CL, Yasui Y, Robison LL, Hudson MM. Factors influencing risk-based care of the childhood cancer survivor in the 21st century. CA Cancer J Clin 2018; 68:133-152. [PMID: 29377070 PMCID: PMC8893118 DOI: 10.3322/caac.21445] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 12/30/2022] Open
Abstract
The population of adult survivors of childhood cancer continues to grow as survival rates improve. Although it is well established that these survivors experience various complications and comorbidities related to their malignancy and treatment, this risk is modified by many factors that are not directly linked to their cancer history. Research evaluating the influence of patient-specific demographic and genetic factors, premorbid and comorbid conditions, health behaviors, and aging has identified additional risk factors that influence cancer treatment-related toxicity and possible targets for intervention in this population. Furthermore, although current long-term follow-up guidelines comprehensively address specific therapy-related risks and provide screening recommendations, the risk profile of the population continues to evolve with ongoing modification of treatment strategies and the emergence of novel therapeutics. To address the multifactorial modifiers of cancer treatment-related health risk and evolving treatment approaches, a patient-centered and risk-adapted approach to care that often requires a multidisciplinary team approach, including medical and behavioral providers, is necessary for this population. CA Cancer J Clin 2018;68:133-152. © 2018 American Cancer Society.
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Affiliation(s)
- Stephanie B Dixon
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Kari L Bjornard
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Nicole M Alberts
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Tara M Brinkman
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Wassim Chemaitilly
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Pediatric Medicine – Division of Endocrinology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Matthew J Ehrhardt
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | | | - Lisa M Force
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Todd M Gibson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Daniel M Green
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Carrie R Howell
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Sue C Kaste
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Radiology, University of Tennessee Health Science Center, Memphis, TN
| | - Anne Kirchhoff
- Department of Pediatrics and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - James L Klosky
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Kevin R Krull
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - John T Lucas
- Department of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Daniel A Mulrooney
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Carmen L Wilson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Melissa M Hudson
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
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Jones ME, Schoemaker MJ, Wright LB, Ashworth A, Swerdlow AJ. Smoking and risk of breast cancer in the Generations Study cohort. Breast Cancer Res 2017; 19:118. [PMID: 29162146 PMCID: PMC5698948 DOI: 10.1186/s13058-017-0908-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/11/2017] [Indexed: 01/07/2023] Open
Abstract
Background Plausible biological reasons exist regarding why smoking could affect breast cancer risk, but epidemiological evidence is inconsistent. Methods We used serial questionnaire information from the Generations Study cohort (United Kingdom) to estimate HRs for breast cancer in relation to smoking adjusted for potentially confounding factors, including alcohol intake. Results Among 102,927 women recruited 2003–2013, with an average of 7.7 years of follow-up, 1815 developed invasive breast cancer. The HR (reference group was never smokers) was 1.14 (95% CI 1.03–1.25; P = 0.010) for ever smokers, 1.24 (95% CI 1.08–1.43; P = 0.002) for starting smoking at ages < 17 years, and 1.23 (1.07–1.41; P = 0.004) for starting smoking 1–4 years after menarche. Breast cancer risk was not statistically associated with interval from initiation of smoking to first birth (P-trend = 0.97). Women with a family history of breast cancer (ever smoker vs never smoker HR 1.35; 95% CI 1.12–1.62; P = 0.002) had a significantly larger HR in relation to ever smokers (P for interaction = 0.039) than women without (ever smoker vs never smoker HR 1.07; 95% CI 0.96–1.20; P = 0.22). The interaction was prominent for age at starting smoking (P = 0.003) and starting smoking relative to age at menarche (P = 0.0001). Conclusions Smoking was associated with a modest but significantly increased risk of breast cancer, particularly among women who started smoking at adolescent or peri-menarcheal ages. The relative risk of breast cancer associated with smoking was greater for women with a family history of the disease. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0908-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, SW7 3RP, UK.
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, SW7 3RP, UK
| | - Lauren B Wright
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, SW7 3RP, UK
| | - Alan Ashworth
- Division of Breast Cancer Research, The Institute of Cancer Research, London, SW7 3RP, UK.,Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, SW7 3RP, UK.,Division of Molecular Pathology, The Institute of Cancer Research, London, SW7 3RP, UK.,Present Address: UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, 94158, USA
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, SW7 3RP, UK.,Division of Breast Cancer Research, The Institute of Cancer Research, London, SW7 3RP, UK
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Derman YE. Clinical Practice Recommendations Based on an Updated Review of Breast Cancer Risk Among Women Treated for Childhood Cancer. J Pediatr Oncol Nurs 2017; 35:65-78. [PMID: 28863725 DOI: 10.1177/1043454217727515] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Breast cancer is the most common secondary malignancy among women treated for childhood cancer. This review highlights interacting etiologies contributing to development of secondary breast cancer to complement guidelines for surveillance and survivorship care and make recommendations for clinical practice. Treatment exposures determine Children's Oncology Group breast cancer surveillance guidelines; those treated with cumulative doses ≥20 Gy chest irradiation should undergo annual magnetic resonance imaging and mammography after age 25 years or 8 years after exposure, whichever comes last. Recent investigations suggest that those treated with cumulative doses ≥10 Gy in fields affecting breast tissue, specifically whole lung, should be counseled for similar surveillance. Childhood sarcoma and leukemia survivors treated with anthracyclines and/or alkylating agents without radiation have increased risk for breast cancer and may require enhanced surveillance. Multigene testing and/or genomic evaluation for predisposition among certain childhood cancer subtypes may prove to be beneficial in identifying those at greatest risk. Pediatric oncology nurses who incorporate this information into survivorship care planning discussions/documents and clinical research endeavors may help reduce breast cancer-related morbidity/mortality for this at-risk population.
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Affiliation(s)
- Yael E Derman
- 1 University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Radiation-associated breast cancer and gonadal hormone exposure: a report from the Childhood Cancer Survivor Study. Br J Cancer 2017. [PMID: 28632729 PMCID: PMC5520518 DOI: 10.1038/bjc.2017.169] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The relationship between hormone exposure and breast cancer risk in women treated with chest radiotherapy for childhood cancer is uncertain. METHODS Participants included 1108 females from the Childhood Cancer Survivor Study who were diagnosed with childhood cancer 1970-1986, treated with chest radiotherapy, and survived to ages ⩾20 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) from Cox models adjusted for chest radiation field, delivered dose, anthracycline exposure, and age at childhood cancer estimated risk. RESULTS Among 195 women diagnosed with breast cancer, 102 tumours were oestrogen-receptor positive (ER+). Breast cancer risk increased with ⩾10 years of ovarian function after chest radiotherapy vs <10 years (HR=2.89, CI 1.56-5.53) and for radiotherapy given within 1 year of menarche vs >1 year from menarche (HR=1.80, CI 1.19-2.72). Risk decreased with decreasing age at menopause (Ptrend=0.014). Risk factors did not differ for ER+ breast cancer. Survivors with an age at menopause <20 years treated with hormone therapy had a lower breast cancer risk than premenopausal survivors (HR=0.47, CI 0.23-0.94). CONCLUSIONS Endogenous hormones are key contributors to breast cancer observed among childhood cancer survivors. Hormone therapy given for premature ovarian insufficiency does not fully replace the function that endogenous hormones have in breast cancer development.
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Džemail D, Dženana D, Avdo Ć, Mulić M. BREAST CANCER AS A SECOND TUMOR AFTER RADIOTHERAPY IN PATIENT WITH HODGKIN’S LYMPHOMA-CASE REPORT AND LITERATURE REVIEW. ACTA MEDICA MEDIANAE 2017. [DOI: 10.5633/amm.2017.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Hodgson D, van Leeuwen F, Ng A, Morton L, Henderson TO. Breast Cancer After Childhood, Adolescent, and Young Adult Cancer: It's Not Just About Chest Radiation. Am Soc Clin Oncol Educ Book 2017; 37:736-745. [PMID: 28561716 DOI: 10.1200/edbk_175668] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Women who have been treated for a childhood, adolescent, or young adult cancer are at an increased risk for developing breast cancer at a young age, and breast cancer accounts for the most common subsequent malignant neoplasm among female childhood and adolescent cancer survivors. Risk of breast cancer in these survivors appears to be a multifaceted relationship between constitutional factors, exposures to radiation therapy (RT) and chemotherapy, and genetic predisposition. Given the significant morbidities and mortality associated with a breast cancer diagnosis, it is imperative that health care providers understand the risks, biology and genetics, recommended surveillance guidelines for early detection, and potential prevention strategies for women who have survived pediatric and young adult cancer.
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Affiliation(s)
- David Hodgson
- From the University of Toronto, Toronto, Ontario; Netherlands Cancer Institute, Amsterdam, Netherlands; Dana-Farber Cancer Institute, Boston, MA; National Cancer Institute, Bethesda, MD; University of Chicago, Chicago, IL
| | - Flora van Leeuwen
- From the University of Toronto, Toronto, Ontario; Netherlands Cancer Institute, Amsterdam, Netherlands; Dana-Farber Cancer Institute, Boston, MA; National Cancer Institute, Bethesda, MD; University of Chicago, Chicago, IL
| | - Andrea Ng
- From the University of Toronto, Toronto, Ontario; Netherlands Cancer Institute, Amsterdam, Netherlands; Dana-Farber Cancer Institute, Boston, MA; National Cancer Institute, Bethesda, MD; University of Chicago, Chicago, IL
| | - Lindsay Morton
- From the University of Toronto, Toronto, Ontario; Netherlands Cancer Institute, Amsterdam, Netherlands; Dana-Farber Cancer Institute, Boston, MA; National Cancer Institute, Bethesda, MD; University of Chicago, Chicago, IL
| | - Tara O Henderson
- From the University of Toronto, Toronto, Ontario; Netherlands Cancer Institute, Amsterdam, Netherlands; Dana-Farber Cancer Institute, Boston, MA; National Cancer Institute, Bethesda, MD; University of Chicago, Chicago, IL
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Breast Cancer in Lymphoma Survivors. Breast Cancer 2017. [DOI: 10.1007/978-3-319-48848-6_30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Shanmugalingam T, Bosco C, Ridley AJ, Van Hemelrijck M. Is there a role for IGF-1 in the development of second primary cancers? Cancer Med 2016; 5:3353-3367. [PMID: 27734632 PMCID: PMC5119990 DOI: 10.1002/cam4.871] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 06/08/2016] [Accepted: 06/24/2016] [Indexed: 12/15/2022] Open
Abstract
Cancer survival rates are increasing, and as a result, more cancer survivors are exposed to the risk of developing a second primary cancer (SPC). It has been hypothesized that one of the underlying mechanisms for this risk could be mediated by variations in insulin-like growth factor-1 (IGF-1). This review summarizes the current epidemiological evidence to identify whether IGF-1 plays a role in the development of SPCs. IGF-1 is known to promote cancer development by inhibiting apoptosis and stimulating cell proliferation. Epidemiological studies have reported a positive association between circulating IGF-1 levels and various primary cancers, such as breast, colorectal, and prostate cancer. The role of IGF-1 in increasing SPC risk has been explored less. Nonetheless, several experimental studies have observed a deregulation of the IGF-1 pathway, which may explain the association between IGF-1 and SPCs. Thus, measuring serum IGF-1 may serve as a useful marker in assessing the risk of SPCs, and therefore, more translational experimental and epidemiological studies are needed to further disentangle the role of IGF-1 in the development of specific SPCs.
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Affiliation(s)
- Thurkaa Shanmugalingam
- Division of Cancer StudiesCancer Epidemiology GroupKing's College LondonLondonUnited Kingdom
| | - Cecilia Bosco
- Division of Cancer StudiesCancer Epidemiology GroupKing's College LondonLondonUnited Kingdom
| | - Anne J. Ridley
- Randall Division of Cell and Molecular BiophysicsKing's College LondonLondonUnited Kingdom
| | - Mieke Van Hemelrijck
- Division of Cancer StudiesCancer Epidemiology GroupKing's College LondonLondonUnited Kingdom
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Wijnen M, van den Heuvel-Eibrink MM, Medici M, Peeters RP, van der Lely AJ, Neggers SJCMM. Risk factors for subsequent endocrine-related cancer in childhood cancer survivors. Endocr Relat Cancer 2016; 23:R299-321. [PMID: 27229933 DOI: 10.1530/erc-16-0113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 05/26/2016] [Indexed: 12/12/2022]
Abstract
Long-term adverse health conditions, including secondary malignant neoplasms, are common in childhood cancer survivors. Although mortality attributable to secondary malignancies declined over the past decades, the risk for developing a solid secondary malignant neoplasm did not. Endocrine-related malignancies are among the most common secondary malignant neoplasms observed in childhood cancer survivors. In this systematic review, we describe risk factors for secondary malignant neoplasms of the breast and thyroid, since these are the most common secondary endocrine-related malignancies in childhood cancer survivors. Radiotherapy is the most important risk factor for secondary breast and thyroid cancer in childhood cancer survivors. Breast cancer risk is especially increased in survivors of Hodgkin lymphoma who received moderate- to high-dosed mantle field irradiation. Recent studies also demonstrated an increased risk after lower-dose irradiation in other radiation fields for other childhood cancer subtypes. Premature ovarian insufficiency may protect against radiation-induced breast cancer. Although evidence is weak, estrogen-progestin replacement therapy does not seem to be associated with an increased breast cancer risk in premature ovarian-insufficient childhood cancer survivors. Radiotherapy involving the thyroid gland increases the risk for secondary differentiated thyroid carcinoma, as well as benign thyroid nodules. Currently available studies on secondary malignant neoplasms in childhood cancer survivors are limited by short follow-up durations and assessed before treatment regimens. In addition, studies on risk-modifying effects of environmental and lifestyle factors are lacking. Risk-modifying effects of premature ovarian insufficiency and estrogen-progestin replacement therapy on radiation-induced breast cancer require further study.
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Affiliation(s)
- M Wijnen
- Department of Pediatric Oncology/HematologyErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands Department of MedicineSection Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M M van den Heuvel-Eibrink
- Department of Pediatric Oncology/HematologyErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands Princess Maxima Center for Pediatric OncologyUtrecht, the Netherlands
| | - M Medici
- Department of MedicineSection Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands Rotterdam Thyroid CenterErasmus University Medical Center, Rotterdam, the Netherlands
| | - R P Peeters
- Department of MedicineSection Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands Rotterdam Thyroid CenterErasmus University Medical Center, Rotterdam, the Netherlands
| | - A J van der Lely
- Department of MedicineSection Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - S J C M M Neggers
- Department of Pediatric Oncology/HematologyErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands Department of MedicineSection Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Sonigo C, Seroka A, Cédrin-Durnerin I, Sermondade N, Sifer C, Grynberg M. History of ABVD alters the number of oocytes vitrified after in vitro maturation in fertility preservation candidates. Future Oncol 2016; 12:1713-9. [PMID: 26960957 DOI: 10.2217/fon-2016-0009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
AIM This retrospective case-control study aimed at analyzing the results of in vitro maturation (IVM) of oocytes, used for fertility preservation (FP), in patients with history of ABVD (adriamycin, bleomycin, vinblastine and dacarbazine) for classical Hodgkin lymphoma. PATIENTS & METHODS A total of 22 candidates for FP, having received ABVD at least 2 years before IVM for FP were studied. IVM results were compared with those of 44 breast cancer patients, without history of chemotherapy, matched for ovarian reserve parameters. RESULTS The number of cumulo-oocyte complexes recovered and the total number of matured oocytes vitrified was lower in patients having received AVBD (5.5 ± 4.8 vs 8.5 ± 4.4 oocytes; p = 0.03 and 3.5 ± 3.7 vs 6 ± 3.0 oocytes; p < 0.04, respectively). CONCLUSION In light of these results, FP should be discussed before ABVD.
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Affiliation(s)
- Charlotte Sonigo
- Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France.,Université Paris XIII, 93000 Bobigny, France
| | - Alice Seroka
- Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Isabelle Cédrin-Durnerin
- Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Nathalie Sermondade
- Service de Cytogénétique et Biologie de la Reproduction, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Christophe Sifer
- Service de Cytogénétique et Biologie de la Reproduction, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Michael Grynberg
- Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France.,Université Paris XIII, 93000 Bobigny, France.,Unité Inserm U1133, Université Paris-Diderot, 75013 Paris, France
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Schaapveld M, Aleman BMP, van Eggermond AM, Janus CPM, Krol ADG, van der Maazen RWM, Roesink J, Raemaekers JMM, de Boer JP, Zijlstra JM, van Imhoff GW, Petersen EJ, Poortmans PMP, Beijert M, Lybeert ML, Mulder I, Visser O, Louwman MWJ, Krul IM, Lugtenburg PJ, van Leeuwen FE. Second Cancer Risk Up to 40 Years after Treatment for Hodgkin's Lymphoma. N Engl J Med 2015; 373:2499-511. [PMID: 26699166 DOI: 10.1056/nejmoa1505949] [Citation(s) in RCA: 406] [Impact Index Per Article: 45.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Survivors of Hodgkin's lymphoma are at increased risk for treatment-related subsequent malignant neoplasms. The effect of less toxic treatments, introduced in the late 1980s, on the long-term risk of a second cancer remains unknown. METHODS We enrolled 3905 persons in the Netherlands who had survived for at least 5 years after the initiation of treatment for Hodgkin's lymphoma. Patients had received treatment between 1965 and 2000, when they were 15 to 50 years of age. We compared the risk of a second cancer among these patients with the risk that was expected on the basis of cancer incidence in the general population. Treatment-specific risks were compared within the cohort. RESULTS With a median follow-up of 19.1 years, 1055 second cancers were diagnosed in 908 patients, resulting in a standardized incidence ratio (SIR) of 4.6 (95% confidence interval [CI], 4.3 to 4.9) in the study cohort as compared with the general population. The risk was still elevated 35 years or more after treatment (SIR, 3.9; 95% CI, 2.8 to 5.4), and the cumulative incidence of a second cancer in the study cohort at 40 years was 48.5% (95% CI, 45.4 to 51.5). The cumulative incidence of second solid cancers did not differ according to study period (1965-1976, 1977-1988, or 1989-2000) (P=0.71 for heterogeneity). Although the risk of breast cancer was lower among patients who were treated with supradiaphragmatic-field radiotherapy not including the axilla than among those who were exposed to mantle-field irradiation (hazard ratio, 0.37; 95% CI, 0.19 to 0.72), the risk of breast cancer was not lower among patients treated in the 1989-2000 study period than among those treated in the two earlier periods. A cumulative procarbazine dose of 4.3 g or more per square meter of body-surface area (which has been associated with premature menopause) was associated with a significantly lower risk of breast cancer (hazard ratio for the comparison with no chemotherapy, 0.57; 95% CI, 0.39 to 0.84) but a higher risk of gastrointestinal cancer (hazard ratio, 2.70; 95% CI, 1.69 to 4.30). CONCLUSIONS The risk of second solid cancers did not appear to be lower among patients treated in the most recent calendar period studied (1989-2000) than among those treated in earlier periods. The awareness of an increased risk of second cancer remains crucial for survivors of Hodgkin's lymphoma. (Funded by the Dutch Cancer Society.).
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Affiliation(s)
- Michael Schaapveld
- From the Departments of Epidemiology (M.S., A.M.E., I.M., I.M.K., F.E.L.), Radiation Oncology (B.M.P.A.), and Hematology (J.P.B.), Netherlands Cancer Institute, and the Department of Hematology, VU University Medical Center Amsterdam (J.M.Z.), Amsterdam, the Netherlands Comprehensive Cancer Organization (M.S., I.M., O.V., M.W.J.L.) and the Departments of Radiation Oncology (J.R.) and Hematology (E.J.P.), University Medical Center Utrecht, Utrecht, the Departments of Radiation Oncology (C.P.M.J.) and Hematology (P.J.L.), Erasmus Medical Center Cancer Institute, Rotterdam, the Department of Radiation Oncology, Leiden University Medical Center, Leiden (A.D.G.K.), the Department of Radiation Oncology, Radboud University Medical Center (R.W.M.M., P.M.P.P.), and the Department of Education and Science, Canisius-Wilhelmina Hospital (I.M.), Nijmegen, the Department of Hematology, Radboud University Medical Center, Nijmegen-Rijnstate, Arnhem (J.M.M.R.), the Departments of Hematology (G.W.I.) and Radiation Oncology (M.B.), University Medical Center Groningen, Groningen, the Department of Radiation Oncology, Dr. Bernard Verbeeten Institute, Tilburg (P.M.P.P.), and the Department of Radiotherapy, Catharina Hospital, Eindhoven (M.L.L.) - all in the Netherlands
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Koo E, Henderson MA, Dwyer M, Skandarajah AR. Management and Prevention of Breast Cancer After Radiation to the Chest for Childhood, Adolescent, and Young Adulthood Malignancy. Ann Surg Oncol 2015; 22 Suppl 3:S545-51. [DOI: 10.1245/s10434-015-4596-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Indexed: 11/18/2022]
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Savage P, Cooke R, O'Nions J, Krell J, Kwan A, Camarata M, Dancy G, Short D, Seckl MJ, Swerdlow A. Effects of Single-Agent and Combination Chemotherapy for Gestational Trophoblastic Tumors on Risks of Second Malignancy and Early Menopause. J Clin Oncol 2015; 33:472-8. [DOI: 10.1200/jco.2014.57.5332] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To assess the risks of second malignancy and early menopause in a large cohort of patients with gestational trophoblastic tumor who were treated with chemotherapy. Patients and Methods A survey of patients treated at Charing Cross Hospital between 1958 and 2000 was performed in 2006 to assemble incidence data for subsequent malignancies and the age at menopause. Treatment records were reviewed for the regimens and durations, and the incidence of subsequent malignancies was compared with that in the national age-matched population. Results Data were obtained for 1,903 patients, with a mean follow-up of 16.9 years. Eighty-six patients developed a subsequent malignancy compared with an expected number of 79 (standardized incidence ratio [SIR], 1.1; 95% CI, 0.9 to 1.3). The overall risk was low for patients treated with single-agent methotrexate and folinic acid (MTX-FA; SIR, 0.7; 95% CI, 0.5 to 1.1) and also for patients treated with etoposide, methotrexate, and dactinomycin followed by cyclophosphamide and vincristine on alternating weeks (EMA-CO) with an SIR of 0.9 (95% CI, 0.4 to 2.2), but there were significantly increased risks of oral cancer, melanoma, meningioma, and leukemia. The cumulative risk of early menopause was low after MTX-FA but was substantial after EMA-CO, reaching 13% by age 40 years and 36% by age 45 years. Conclusion Subsequent cancer risks for patients cured of gestational trophoblastic tumors with modern chemotherapy appear similar to those of the normal population with no overall increased risk of malignancy after MTX-FA or EMA-CO. However, there was evidence of an increased risk of leukemia after EMA-CO and some evidence of other site-specific increased risks based on small patient numbers. All major treatments except MTX-FA increased the risk of early menopause.
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Affiliation(s)
- Philip Savage
- Philip Savage, Jenny O'Nions, Jon Krell, Amy Kwan, Michelle Camarata, Gairin Dancy, Dee Short, and Michael J. Seckl, Charing Cross Hospital, Imperial Hospitals National Health Service Trust, London; and Rosie Cooke and Anthony Swerdlow, Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Rosie Cooke
- Philip Savage, Jenny O'Nions, Jon Krell, Amy Kwan, Michelle Camarata, Gairin Dancy, Dee Short, and Michael J. Seckl, Charing Cross Hospital, Imperial Hospitals National Health Service Trust, London; and Rosie Cooke and Anthony Swerdlow, Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Jenny O'Nions
- Philip Savage, Jenny O'Nions, Jon Krell, Amy Kwan, Michelle Camarata, Gairin Dancy, Dee Short, and Michael J. Seckl, Charing Cross Hospital, Imperial Hospitals National Health Service Trust, London; and Rosie Cooke and Anthony Swerdlow, Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Jon Krell
- Philip Savage, Jenny O'Nions, Jon Krell, Amy Kwan, Michelle Camarata, Gairin Dancy, Dee Short, and Michael J. Seckl, Charing Cross Hospital, Imperial Hospitals National Health Service Trust, London; and Rosie Cooke and Anthony Swerdlow, Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Amy Kwan
- Philip Savage, Jenny O'Nions, Jon Krell, Amy Kwan, Michelle Camarata, Gairin Dancy, Dee Short, and Michael J. Seckl, Charing Cross Hospital, Imperial Hospitals National Health Service Trust, London; and Rosie Cooke and Anthony Swerdlow, Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Michelle Camarata
- Philip Savage, Jenny O'Nions, Jon Krell, Amy Kwan, Michelle Camarata, Gairin Dancy, Dee Short, and Michael J. Seckl, Charing Cross Hospital, Imperial Hospitals National Health Service Trust, London; and Rosie Cooke and Anthony Swerdlow, Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Gairin Dancy
- Philip Savage, Jenny O'Nions, Jon Krell, Amy Kwan, Michelle Camarata, Gairin Dancy, Dee Short, and Michael J. Seckl, Charing Cross Hospital, Imperial Hospitals National Health Service Trust, London; and Rosie Cooke and Anthony Swerdlow, Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Dee Short
- Philip Savage, Jenny O'Nions, Jon Krell, Amy Kwan, Michelle Camarata, Gairin Dancy, Dee Short, and Michael J. Seckl, Charing Cross Hospital, Imperial Hospitals National Health Service Trust, London; and Rosie Cooke and Anthony Swerdlow, Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Michael J. Seckl
- Philip Savage, Jenny O'Nions, Jon Krell, Amy Kwan, Michelle Camarata, Gairin Dancy, Dee Short, and Michael J. Seckl, Charing Cross Hospital, Imperial Hospitals National Health Service Trust, London; and Rosie Cooke and Anthony Swerdlow, Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Anthony Swerdlow
- Philip Savage, Jenny O'Nions, Jon Krell, Amy Kwan, Michelle Camarata, Gairin Dancy, Dee Short, and Michael J. Seckl, Charing Cross Hospital, Imperial Hospitals National Health Service Trust, London; and Rosie Cooke and Anthony Swerdlow, Institute of Cancer Research, Sutton, Surrey, United Kingdom
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Lisik-Habib M, Czernek U, Dębska-Szmich S, Krakowska M, Kubicka-Wołkowska J, Potemski P. Secondary cancer in a survivor of Hodgkin's lymphoma: A case report and review of the literature. Oncol Lett 2014; 9:964-966. [PMID: 25621073 PMCID: PMC4301521 DOI: 10.3892/ol.2014.2799] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 10/31/2014] [Indexed: 12/15/2022] Open
Abstract
Hodgkin’s lymphoma (HL) is one of the most curable malignant diseases in adults. However, HL patients have a higher risk of developing second malignancies compared with the general population. The population of adult cancer survivors is growing, thus, the long-term effects of cancer treatment, including secondary cancer development, have become an increasingly important concern in the field of oncology. The current study presents the case of a female HL survivor who developed two secondary malignancies within 29 years of follow-up. Furthermore, a review of the literature was conducted, which focused on secondary breast and gastrointestinal cancers in HL survivors.
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Affiliation(s)
- Maja Lisik-Habib
- Department of Chemotherapy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz 93-513, Poland
| | - Urszula Czernek
- Department of Chemotherapy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz 93-513, Poland
| | - Sylwia Dębska-Szmich
- Department of Chemotherapy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz 93-513, Poland
| | - Magdalena Krakowska
- Department of Chemotherapy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz 93-513, Poland
| | - Joanna Kubicka-Wołkowska
- Department of Chemotherapy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz 93-513, Poland
| | - Piotr Potemski
- Department of Chemotherapy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz 93-513, Poland
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Allen SD, Wallis MG, Cooke R, Swerdlow AJ. Radiologic Features of Breast Cancer after Mantle Radiation Therapy for Hodgkin Disease: A Study of 230 Cases. Radiology 2014; 272:73-8. [DOI: 10.1148/radiol.14131789] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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van Dijk IWEM, van Os RM, van de Kamer JB, Franken NAP, van der Pal HJH, Koning CCE, Caron HN, Ronckers CM, Kremer LCM. The use of equivalent radiation dose in the evaluation of late effects after childhood cancer treatment. J Cancer Surviv 2014; 8:638-46. [DOI: 10.1007/s11764-014-0373-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 05/28/2014] [Indexed: 12/25/2022]
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Morton LM, Swerdlow AJ, Schaapveld M, Ramadan S, Hodgson DC, Radford J, van Leeuwen FE. Current knowledge and future research directions in treatment-related second primary malignancies. EJC Suppl 2014; 12:5-17. [PMID: 26217162 PMCID: PMC4250537 DOI: 10.1016/j.ejcsup.2014.05.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 03/26/2014] [Indexed: 01/13/2023] Open
Abstract
Currently, 17-19% of all new primary malignancies occur in survivors of cancer, causing substantial morbidity and mortality. Research has shown that cancer treatments are important contributors to second malignant neoplasm (SMN) risk. In this paper we summarise current knowledge with regard to treatment-related SMNs and provide recommendations for future research. We address the risks associated with radiotherapy and systemic treatments, modifying factors of treatment-related risks (genetic susceptibility, lifestyle) and the potential benefits of screening and interventions. Research priorities were identified during a workshop at the 2014 Cancer Survivorship Summit organised by the European Organisation for Research and Treatment of Cancer. Recently, both systemic cancer treatments and radiotherapy approaches have evolved rapidly, with the carcinogenic potential of new treatments being unknown. Also, little knowledge is available about modifying factors of treatment-associated risk, such as genetic variants and lifestyle. Therefore, large prospective studies with biobanking, high quality treatment data (radiation dose-volume, cumulative drug doses), and data on other cancer risk factors are needed. International collaboration will be essential to have adequate statistical power for such investigations. While screening for SMNs is included in several follow-up guidelines for cancer survivors, its effectiveness in this special population has not been demonstrated. Research into the pathogenesis, tumour characteristics and survival of SMNs is essential, as well as the development of interventions to reduce SMN-related morbidity and mortality. Prediction models for SMN risk are needed to inform initial treatment decisions, balancing chances of cure and SMNs and to identify high-risk subgroups of survivors eligible for screening.
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Affiliation(s)
- Lindsay M. Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - Anthony J. Swerdlow
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, United Kingdom
| | - Michael Schaapveld
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Safaa Ramadan
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - David C. Hodgson
- Radiation Medicine Program, Princess Margaret Hospital, University Health Network, and Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - John Radford
- The University of Manchester and The Christie National Health Service Foundation Trust, Manchester, United Kingdom
| | - Flora E. van Leeuwen
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Bodicoat DH, Schoemaker MJ, Jones ME, McFadden E, Griffin J, Ashworth A, Swerdlow AJ. Timing of pubertal stages and breast cancer risk: the Breakthrough Generations Study. Breast Cancer Res 2014; 16:R18. [PMID: 24495528 PMCID: PMC3978643 DOI: 10.1186/bcr3613] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 01/30/2014] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Breast development and hormonal changes at puberty might affect breast cancer risk, but epidemiological analyses have focussed largely on age at menarche and not at other pubertal stages. METHODS We investigated associations between the timing of pubertal stages and breast cancer risk using data from a cohort study of 104,931 women (Breakthrough Generations Study, UK, 2003-2013). Pubertal variables were reported retrospectively at baseline. Breast cancer risk was analysed using Cox regression models with breast cancer diagnosis as the outcome of interest, attained age as the underlying time variable, and adjustment for potentially confounding variables. RESULTS During follow-up (mean = 4.1 years), 1094 breast cancers (including ductal carcinoma in situ) occurred. An increased breast cancer risk was associated with earlier thelarche (age when breast growth begins; HR [95% CI] = 1.23 [1.02, 1.48], 1 [referent] and 0.80 [0.69, 0.93] for ≤10, 11-12 and ≥13 years respectively), menarche (initiation of menses; 1.06 [0.93, 1.21], 1 [referent] and 0.78 [0.62, 0.99] for ≤12, 13-14 and ≥15 years), regular periods (0.99 [0.83, 1.18], 1 [referent] and 0.74 [0.59, 0.92] for ≤12, 13-14 and ≥15 years) and age reached adult height (1.25 [1.03, 1.52], 1 [referent] and 1.07 [0.87, 1.32] for ≤14, 15-16 and ≥17 years), and with increased time between thelarche and menarche (0.87 [0.65, 1.15], 1 [referent], 1.14 [0.96, 1.34] and 1.27 [1.04, 1.55] for <0, 0, 1 and ≥2 years), and shorter time between menarche and regular periods (1 [referent], 0.87 [0.73, 1.04] and 0.66 [0.50, 0.88] for 0, 1 and ≥2 years). These associations were generally similar when considered separately for premenopausal and postmenopausal breast cancer. CONCLUSIONS Breast duct development may be a time of heightened susceptibility to risk of carcinogenesis, and greater attention needs to be given to the relation of breast cancer risk to the different stages of puberty.
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Affiliation(s)
- Danielle H Bodicoat
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, Leicestershire LE5 4PW, UK
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - Michael E Jones
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - Emily McFadden
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Department of Primary Care Health Sciences, Oxford University, Oxford, UK
| | - James Griffin
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - Alan Ashworth
- Breakthrough Breast Cancer Research Centre and Division of Molecular Pathology, Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, Institute of Cancer Research, Sutton, UK
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Division of Breast Cancer Research, Institute of Cancer Research, Sutton, UK
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