TY - JOUR
T1 - Radiation dose and breast cancer risk in patients treated for cancer of the cervix
AU - Boice, John D.
AU - Blettner, Maria
AU - Kleinerman, Ruth A.
AU - Engholm, Göran
AU - Stovall, Marilyn
AU - Lisco, Hermann
AU - Austin, Donald F.
AU - Bosch, Antonio
AU - Harlan, Linda
AU - Krementz, Edward T.
AU - Latourette, Howard B.
AU - Merrill, James A.
AU - Peters, Lester J.
AU - Schulz, Milford D.
AU - Wactawski, Jean
AU - Storm, Hans H.
AU - Björkholm, Elisabet
AU - Pettersson, Folke
AU - Bell, Cm Janine
AU - Coleman, Michel P.
AU - Fraser, Patricia
AU - Neal, Frank E.
AU - Prior, Patricia
AU - Won Choi, N.
AU - Hislop, T. Gregory
AU - Koch, Maria
AU - Kreiger, Nancy
AU - Robb, Dorothy
AU - Robson, Diane
AU - Thomson, D. H.
AU - Lochmüller, H.
AU - Fournier, Dietrich Von
AU - Frischkorn, Rolf
AU - Kjørstad, Kjell E.
AU - Rimpelä, Arja
AU - Pejovic, Marie‐Héléne ‐H
AU - Kirn, Vera Pompe
AU - Stankusova, Hanna
AU - Pisani, Paola
AU - Sigurdsson, Kristjan
AU - Hutchison, George B.
AU - Macmahon, Brian
PY - 1989
Y1 - 1989
N2 - The relationship between breast cancer and radiation treatment for cervical cancer was evaluated in an international study of 953 women who subsequently developed breast cancer and 1,806 matched controls. Radiation doses to the breast (average 0.31 Gy) and ovaries (average 32 Gy) were reconstructed for exposed subjects on the basis of their original radiotherapy records. Overall, 88% of the breast cancer cases and 89% of the controls received radiation treatment [relative risk (RR) = 0.88; 95% confidence interval (CI) = 0.7‐1.2]. Among women with intact ovaries (561 cases, 1,037 controls), radiotherapy was linked to a significant 35% reduction in breast cancer risk, attributable in all likelihood to the cessation of ovarian function. Ovarian doses of 6 Gy were sufficient to reduce breast cancer risk but larger doses did not reduce risk further. This saturation‐type response is probably due to the killing of a critical number of ovarian cells. Cervical cancer patients without ovaries (145 cases, 284 controls) were analyzed separately because such women are at especially low natural risk for breast cancer development. In theory, any effect of low‐dose breast exposure, received incidentally during treatment for cervical cancer, should be more readily detectable. Among women without ovaries, there was a slight increase in breast cancer risk (RR = 1.07; 95% CI = 0.6‐2.0), and a suggestion of a dose response with the RR being 1.0, 0.7, 1.5 and 3.1 for breast doses of 0,0.01‐0.24, 0.25‐0.49 and 0.50 + Gy, respectively. However, this trend of increasing RR was not statistically significant, if low‐dose radiation increases the risk of breast cancer among women over age 40 years, it appears that the risk is much lower than would be predicted from studies of younger women exposed to higher doses.
AB - The relationship between breast cancer and radiation treatment for cervical cancer was evaluated in an international study of 953 women who subsequently developed breast cancer and 1,806 matched controls. Radiation doses to the breast (average 0.31 Gy) and ovaries (average 32 Gy) were reconstructed for exposed subjects on the basis of their original radiotherapy records. Overall, 88% of the breast cancer cases and 89% of the controls received radiation treatment [relative risk (RR) = 0.88; 95% confidence interval (CI) = 0.7‐1.2]. Among women with intact ovaries (561 cases, 1,037 controls), radiotherapy was linked to a significant 35% reduction in breast cancer risk, attributable in all likelihood to the cessation of ovarian function. Ovarian doses of 6 Gy were sufficient to reduce breast cancer risk but larger doses did not reduce risk further. This saturation‐type response is probably due to the killing of a critical number of ovarian cells. Cervical cancer patients without ovaries (145 cases, 284 controls) were analyzed separately because such women are at especially low natural risk for breast cancer development. In theory, any effect of low‐dose breast exposure, received incidentally during treatment for cervical cancer, should be more readily detectable. Among women without ovaries, there was a slight increase in breast cancer risk (RR = 1.07; 95% CI = 0.6‐2.0), and a suggestion of a dose response with the RR being 1.0, 0.7, 1.5 and 3.1 for breast doses of 0,0.01‐0.24, 0.25‐0.49 and 0.50 + Gy, respectively. However, this trend of increasing RR was not statistically significant, if low‐dose radiation increases the risk of breast cancer among women over age 40 years, it appears that the risk is much lower than would be predicted from studies of younger women exposed to higher doses.
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U2 - 10.1002/ijc.2910440103
DO - 10.1002/ijc.2910440103
M3 - Article
C2 - 2744900
AN - SCOPUS:0024333215
SN - 0020-7136
VL - 44
SP - 7
EP - 16
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 1
ER -