Occurrence of breast cancer after chest wall irradiation for pediatric cancer, as detected by a multimodal screening program

Monica Terenziani, Patrizia Casalini, Gianfranco Scaperrotta, Lorenza Gandola, Giovanna Trecate, Serena Catania, Graziella Cefalo, Alberto Conti, Maura Massimino, Cristina Meazza, Marta Podda, Filippo Spreafico, Laura Suman, Massimiliano Gennaro

Research output: Contribution to journalArticle

Abstract

Purpose: To assess the occurrence of breast cancer (BC) after exposure to ionizing radiation for pediatric cancer, by means of a multimodal screening program. Patients and Methods: We identified 86 patients who had received chest wall radiation therapy for pediatric cancer. Clinical breast examination (CBE), ultrasound (US), and mammography (MX) were performed yearly. Magnetic resonance imaging (MRI) was added as of October 2007. We calculated the risk of developing BC by radiation therapy dose, patient age, and menarche before or after primary treatment. Results: Eleven women developed a BC from July 2002-February 2010. The sensitivity of the screening methods was 36% for CBE, 73% for MX, 55% for US, and 100% for MRI; the specificity was 91%, 99%, 95%, and 80% for CBE, MX, US, and MRI, respectively. The annual BC detection rate was 2.9%. The median age at BC diagnosis was 33 years. Although age had no influence, menarche before as opposed to after radiation therapy correlated significantly with BC (P=.027): the annual BC detection rate in the former subgroup was 5.3%. Conclusions: Mammography proved more sensitive and specific in our cohort of young women than CBE or US. Magnetic resonance imaging proved 100% sensitive (but this preliminary finding needs to be confirmed). Our cohort of patients carries a 10-fold BC risk at an age more than 20 years younger than in the general population.

Original languageEnglish
Pages (from-to)35-39
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume85
Issue number1
DOIs
Publication statusPublished - Jan 1 2013

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chest
Thoracic Wall
breast
screening
cancer
occurrences
Pediatrics
Breast Neoplasms
irradiation
Neoplasms
Breast
Magnetic Resonance Imaging
Menarche
Radiotherapy
magnetic resonance
examination
radiation therapy
Mammary Ultrasonography
Mammography
Ionizing Radiation

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

@article{71b57fee4c9746c1a7d145006b8ff090,
title = "Occurrence of breast cancer after chest wall irradiation for pediatric cancer, as detected by a multimodal screening program",
abstract = "Purpose: To assess the occurrence of breast cancer (BC) after exposure to ionizing radiation for pediatric cancer, by means of a multimodal screening program. Patients and Methods: We identified 86 patients who had received chest wall radiation therapy for pediatric cancer. Clinical breast examination (CBE), ultrasound (US), and mammography (MX) were performed yearly. Magnetic resonance imaging (MRI) was added as of October 2007. We calculated the risk of developing BC by radiation therapy dose, patient age, and menarche before or after primary treatment. Results: Eleven women developed a BC from July 2002-February 2010. The sensitivity of the screening methods was 36{\%} for CBE, 73{\%} for MX, 55{\%} for US, and 100{\%} for MRI; the specificity was 91{\%}, 99{\%}, 95{\%}, and 80{\%} for CBE, MX, US, and MRI, respectively. The annual BC detection rate was 2.9{\%}. The median age at BC diagnosis was 33 years. Although age had no influence, menarche before as opposed to after radiation therapy correlated significantly with BC (P=.027): the annual BC detection rate in the former subgroup was 5.3{\%}. Conclusions: Mammography proved more sensitive and specific in our cohort of young women than CBE or US. Magnetic resonance imaging proved 100{\%} sensitive (but this preliminary finding needs to be confirmed). Our cohort of patients carries a 10-fold BC risk at an age more than 20 years younger than in the general population.",
author = "Monica Terenziani and Patrizia Casalini and Gianfranco Scaperrotta and Lorenza Gandola and Giovanna Trecate and Serena Catania and Graziella Cefalo and Alberto Conti and Maura Massimino and Cristina Meazza and Marta Podda and Filippo Spreafico and Laura Suman and Massimiliano Gennaro",
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T1 - Occurrence of breast cancer after chest wall irradiation for pediatric cancer, as detected by a multimodal screening program

AU - Terenziani, Monica

AU - Casalini, Patrizia

AU - Scaperrotta, Gianfranco

AU - Gandola, Lorenza

AU - Trecate, Giovanna

AU - Catania, Serena

AU - Cefalo, Graziella

AU - Conti, Alberto

AU - Massimino, Maura

AU - Meazza, Cristina

AU - Podda, Marta

AU - Spreafico, Filippo

AU - Suman, Laura

AU - Gennaro, Massimiliano

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Purpose: To assess the occurrence of breast cancer (BC) after exposure to ionizing radiation for pediatric cancer, by means of a multimodal screening program. Patients and Methods: We identified 86 patients who had received chest wall radiation therapy for pediatric cancer. Clinical breast examination (CBE), ultrasound (US), and mammography (MX) were performed yearly. Magnetic resonance imaging (MRI) was added as of October 2007. We calculated the risk of developing BC by radiation therapy dose, patient age, and menarche before or after primary treatment. Results: Eleven women developed a BC from July 2002-February 2010. The sensitivity of the screening methods was 36% for CBE, 73% for MX, 55% for US, and 100% for MRI; the specificity was 91%, 99%, 95%, and 80% for CBE, MX, US, and MRI, respectively. The annual BC detection rate was 2.9%. The median age at BC diagnosis was 33 years. Although age had no influence, menarche before as opposed to after radiation therapy correlated significantly with BC (P=.027): the annual BC detection rate in the former subgroup was 5.3%. Conclusions: Mammography proved more sensitive and specific in our cohort of young women than CBE or US. Magnetic resonance imaging proved 100% sensitive (but this preliminary finding needs to be confirmed). Our cohort of patients carries a 10-fold BC risk at an age more than 20 years younger than in the general population.

AB - Purpose: To assess the occurrence of breast cancer (BC) after exposure to ionizing radiation for pediatric cancer, by means of a multimodal screening program. Patients and Methods: We identified 86 patients who had received chest wall radiation therapy for pediatric cancer. Clinical breast examination (CBE), ultrasound (US), and mammography (MX) were performed yearly. Magnetic resonance imaging (MRI) was added as of October 2007. We calculated the risk of developing BC by radiation therapy dose, patient age, and menarche before or after primary treatment. Results: Eleven women developed a BC from July 2002-February 2010. The sensitivity of the screening methods was 36% for CBE, 73% for MX, 55% for US, and 100% for MRI; the specificity was 91%, 99%, 95%, and 80% for CBE, MX, US, and MRI, respectively. The annual BC detection rate was 2.9%. The median age at BC diagnosis was 33 years. Although age had no influence, menarche before as opposed to after radiation therapy correlated significantly with BC (P=.027): the annual BC detection rate in the former subgroup was 5.3%. Conclusions: Mammography proved more sensitive and specific in our cohort of young women than CBE or US. Magnetic resonance imaging proved 100% sensitive (but this preliminary finding needs to be confirmed). Our cohort of patients carries a 10-fold BC risk at an age more than 20 years younger than in the general population.

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