ABCR  Vol.7 No.3 , July 2018
Role of Radiotherapy-Induced Malignancies in Patients with Both Breast and Lung Cancer Diagnoses
Abstract: Background:Breast and lung cancer are two of the most commonly diagnosed cancers in North America. While patients are living longer with advances in treatment and supportive care, some patients are being diagnosed with a second malignancy. The primary objective in this study was to assess the correlation between the development of an ipsilateral lung cancer or breast cancer, and prior radiation therapy. In addition, we sought to report the survival outcomes of patients in these clinical scenarios. Methods: We conducted a single institution (the Ottawa Hospital Cancer Centre) retrospective review of patients with the diagnoses of both breast and lung cancer treated between 1995 and 2013. Patients were included if they received radiation for a breast primary, and subsequently developed an ipsilateral lung primary, or vice-versa. Data included patient demographics, life factors, tumor location and subtype, cancer stages, treatment modalities, and survival outcomes. Results: Of 252 patients included in the study, 217 patients developed a breast primary first, with 35 patients developing a lung primary first. Median disease-free survival from the second primary diagnosis was 36 months in breast primary first patients, and 59 months in the lung primary first cohort. There was no significant correlation between the laterality of radiation treatment and side of second primary based on Fisher’s exact test. Conclusions: Our data reveal no association between side of radiation treatment and subsequent cancer development. The benefits of radiotherapy outweigh the risk of radiation-induced primaries. Longer term studies with matched patient cohorts are required to further assess treatment and life factors that may contribute towards the development of second malignancies.
Cite this paper: Nguyen, E. , Nicholas, G. and Song, X. (2018) Role of Radiotherapy-Induced Malignancies in Patients with Both Breast and Lung Cancer Diagnoses. Advances in Breast Cancer Research, 7, 231-242. doi: 10.4236/abcr.2018.73014.

[1]   Harvey, E.B. and Brinton, L.A. (1985) Second Cancer Following Cancer of the Breast in Connecticut, 1935-82. NCI Monogr, 68, 99-112.

[2]   Ewertz, M. and Mouridsen, H.T. (1985) Second Cancer Following Cancer of the Female Breast in Denmark, 1943-1980. NCI Monogr, 68, 325-329.

[3]   Teppo, L., Pukkala, E. and Saxen, E. (1985) Multiple Cancer—An Epidemiological Exercise in Finland. JNCI, 75, 207-217.

[4]   Murakami, R., Hiyama, T., Hanai, A. and Fujimoto, I. (1987) Second Primary Cancers Following Female Breast Cancer in Osaka, Japan—A Population Based Cohort Study. Japanese Journal of Clinical Oncology, 17, 293-302.

[5]   Brenner, H., Siegle, S., Stegmeier, C. and Ziegler, H. (1993) Second Primary Neoplasms Following Breast Cancer in Saarland, Germany, 1968-1987. European Journal of Cancer, 10, 1410-1414.

[6]   Levi, F., Randimbison, L., Te, V.C., Rolland-Portal, I., Franceschi, S., et al. (1993) Multiple Primary Cancers in the Vaud Cancer Registry, Switzerland, 1974-89. British Journal of Cancer, 67, 391-395.

[7]   Ford, D. and Easton, D.F. (1995) The Genetics of Breast and Ovarian Cancer. British Journal of Cancer, 72, 805-812.

[8]   Thompson, D.E., Mabuchi, K., Ron, E., Soda, M., Yokunaga, M., et al. (1994) Cancer Incidence in Atomic Bomb Survivors. Part II: Solid Tumors, 1958-1987. Radiation Research, 137, 17-67.

[9]   Travis, L.B., Curtis, R.E., Bennet, W.P., Hankey, B.F., Travis, W.D., et al. (1995) Lung Cancer after Hodgkin’s Disease. JNCI, 87, 1324-1327.

[10]   Wagoner, J.K., Archer, V.E., Lundin, F.E., Holaday, D.A. and Lloyd, J.W. (1965) Radiation as a Cause of Lung Cancer among Uranium Miners. The New England Journal of Medicine, 273, 181-188.

[11]   Rivina, L. and Schiestl, R. (2013) Mouse Models of Radiation-Induced Cancers. Advances in Genetics, 84, 83-122.

[12]   Lee, B., Lee, S., Sung, J. and Yoon, M. (2014) Radiotherapy-Induced Secondary Cancerrisk for Breast Cancer: 3D Conformal Therapy versus IMRT versus VMAT. Journal of Radiological Protection, 34, 325-331.

[13]   Butts, C.A., Ding, K., Seymour, L., Twumasi-Ankrah, P., Graham, B., et al. (2010) Randomized Phase III Trial of Vinorelbine plus Cisplatin Compared with Observation in Completed Resected Stage IB and II Non-Small-Cell Lung Cancer: Updated Survival Analysis of JBR-10. Journal of Clinical Oncology, 28, 29-34.

[14]   Albain, K.S., Swann, R.S., Rusch, V.R., Turrisi, A.T., Shepher, F.A., et al. (2009) Radiotherapy plus Chemotherapy with or without Surgical Resection for Stage III Non-Small Cell Lung Cancer. Lancet, 374, 379-386.

[15]   Schaapveld, M., Visser, O., Louwman, M.J., de Vries, E.G., Willemse, P.H., et al. (2008) Risk of New Primary Nonbreast Cancers after Breast Cancer Treatment: A Dutch Population-Based Study. Journal of Clinical Oncology, 26, 1239-1246.

[16]   Marcu, L.G., Santos, A. and Bezak, E. (2014) Risk of Second Primary Cancer after Breast Cancer Treatment. European Journal of Cancer Care, 23, 51-64.

[17]   Evans, H.S., Lewis, C.M., Robinson, D., Bell, C.J., Moller, H., et al. (2001) Incidence of Multiple Primary Cancers in a Cohort of Women Diagnosed with Breast Cancer in Southeast England. British Journal of Cancer, 84, 435-440.

[18]   Berrington de Gonzalez, A., Curtis, R.E., Gilbert, E., Berg, C.D., Smith, S.A., et al. (2010) Second Solid Cancers after Radiotherapy for Breast Cancer in SEER Cancer Registries. British Journal of Cancer, 102, 220-226.

[19]   Zablotska, L.B. and Neugut, A.I. (2003) Lung Carcinoma after Radiation Therapy in Women Treated with Lumpectomy or Mastectomy for Primary Breast Carcinoma. Cancer, 97, 1404-1411.

[20]   Hall, E.J. and Phil, D. (2006) Intensity-Modulated Radiation Therapy, Protons, and the Risk of Second Cancers. International Journal of Radiation Oncology, Biology, Physics, 65, 1-7.