Yi-Jhih Huang1, Tsai-Wang Huang1, Fu-Huang Lin2, Chi-Hsiang Chung3, Chang-Huei Tsao4, Wu-Chien Chien5. 1. Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Republic of China. 2. School of Public Health, National Defense Medical Center, Taipei, Republic of China. 3. School of Public Health, National Defense Medical Center, Taipei, Republic of China; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Republic of China. 4. Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Republic of China. 5. School of Public Health, National Defense Medical Center, Taipei, Republic of China; Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Republic of China. Electronic address: chienwu@mail.ndmctsgh.edu.tw.
Abstract
INTRODUCTION: Although the risk factors for lung cancer are well documented, whether previous radiation therapy (RT) to treat breast cancer (BC) increases the incidence of second primary lung cancer remains unclear. We determined the overall incidence of second primary lung cancer after previous RT for all clinical stages of BC. METHODS: After an analysis of the Longitudinal Health Insurance Database, 986,713 individuals were randomly enrolled from 2000 to 2010 for cohort analysis. All women with newly diagnosed invasive BC, aged 18 years or older, and without other types of malignancy before 2000 or in the follow-up periods were enrolled and allocated to the RT or non-RT groups. Age, comorbidities, insurance premium, urbanization level, location, date of event, and hospital care level were analyzed. The hazard ratios of parameters were calculated by Cox regression analysis. RESULTS: A total of 7408 individuals met the inclusion criteria, including 5695 patients with BC who underwent RT and 128 (2.25%) in whom lung cancer developed. In contrast, lung cancer was diagnosed in only four of 1713 individuals in the non-RT group (0.23%) during the follow-up period. Cox regression analysis showed that the adjusted hazard ratio was 10.078 times higher in the RT group than in the non-RT group for individuals with previous BC. CONCLUSIONS: The incidence of second primary lung cancer was significantly higher in the RT group than in the non-RT group for individuals with previous BC. Patients with BC treated by RT should be extensively surveyed to assess the incidence of subsequent lung cancer.
INTRODUCTION: Although the risk factors for lung cancer are well documented, whether previous radiation therapy (RT) to treat breast cancer (BC) increases the incidence of second primary lung cancer remains unclear. We determined the overall incidence of second primary lung cancer after previous RT for all clinical stages of BC. METHODS: After an analysis of the Longitudinal Health Insurance Database, 986,713 individuals were randomly enrolled from 2000 to 2010 for cohort analysis. All women with newly diagnosed invasive BC, aged 18 years or older, and without other types of malignancy before 2000 or in the follow-up periods were enrolled and allocated to the RT or non-RT groups. Age, comorbidities, insurance premium, urbanization level, location, date of event, and hospital care level were analyzed. The hazard ratios of parameters were calculated by Cox regression analysis. RESULTS: A total of 7408 individuals met the inclusion criteria, including 5695 patients with BC who underwent RT and 128 (2.25%) in whom lung cancer developed. In contrast, lung cancer was diagnosed in only four of 1713 individuals in the non-RT group (0.23%) during the follow-up period. Cox regression analysis showed that the adjusted hazard ratio was 10.078 times higher in the RT group than in the non-RT group for individuals with previous BC. CONCLUSIONS: The incidence of second primary lung cancer was significantly higher in the RT group than in the non-RT group for individuals with previous BC. Patients with BC treated by RT should be extensively surveyed to assess the incidence of subsequent lung cancer.
Authors: Bhavana V Chapman; Diane Liu; Yu Shen; Oluwafikayo O Olamigoke; David S Lakomy; Angelica M Gutierrez Barrera; Shane R Stecklein; Gabriel O Sawakuchi; Scott J Bright; Isabelle Bedrosian; Jennifer K Litton; Benjamin D Smith; Wendy A Woodward; George H Perkins; Karen E Hoffman; Michael C Stauder; Eric A Strom; Banu K Arun; Simona F Shaitelman Journal: Int J Radiat Oncol Biol Phys Date: 2021-10-03 Impact factor: 8.013
Authors: Anna-Karin Wennstig; Charlotta Wadsten; Hans Garmo; Mikael Johansson; Irma Fredriksson; Carl Blomqvist; Lars Holmberg; Greger Nilsson; Malin Sund Journal: NPJ Breast Cancer Date: 2021-06-01