Secondary malignancy estimation in patients after mastectomy and adjuvant therapy

Abstract

Aim: Secondary malignancy estimation after radiotherapy of post mastectomy patients is becoming an important subject for comparative treatment planning. The data from modern treatment planning systems provide accurate three-dimensional dose distributions for each individual patients, thereby opening up new possibilities for more precise estimates of secondary cancer incidence rates in the irradiated organs.

Methods: This study estimates the probability of secondary malignancy using radiobiological model for post mastectomy patients in a low-resource center, Nigeria. The secondary cancer complication probability (SCCP) was computed for linear, linear-exponent and linear-plateau models.

Results: The result shows that comparing the three models the mean SCCP for the contralateral breast ranged between 0.41%-0.93%; for the lung (0.34%-5.93%); while for the chest wall is between 0.65%-31.95%. Also, the result showed that based on the differential dose volume histogram, the SCCP in the chest wall is highest compared to the lung and contralateral breast; while the linear model overestimate the risk of secondary malignancy, the linear-exponent and the linear plateaus gave values not outrageously high.

Conclusion: The models in this study have shown that the risk of secondary malignancy in these post mastectomy patients is low.

Keywords

Probability / radiobiological model / complication / malignancy

References

[1] Assi HA,Dbouk H,Mouhieddine TH.Epidemiology and prognosis of breast cancer in young women.J Thorac Dis2013;

[2] Olajide TO,Habeebu MO,Afolayan MO.Awareness and practice of breast screening and its impact on early detection and presentation among breast cancer patients attending a clinic in Lagos, Nigeria.Niger J Clin Pract2014;17:802-7

[3] Darby SC,McGale P,Blom-Goldman U,Correa C,Gagliardi G,Jensen MB,Peto R,Taylor C.Risk of ischemic heart disease in women after radiotherapy for breast cancer.N Engl J Med2013;368:987-98

[4] Clarke M,Darby S,Elphinstone P,Godwin J,Hicks C,MacKinnon E,McHugh T,Taylor C.Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials.Lancet2005;366:2087-106

[5] Fowble B,Freedman G,Anderson P.Second cancers after conservative surgery and radiation for stages I-II breast cancer: identifying a subset of women at increased risk.Int J Radiat Oncol Biol Phys2001;51:679-90

[6] Raymond JS.Multiple primary tumours in women following breast cancer, 1973-2000.Br J Cancer2006;94:1745-50 PMCID:PMC2361329

[7] Mellemkjaer L,Olsen JH,Hemminki K,Andersen A,Pukkala E,Kliewer EV,Kee-Seng C,Martos C,Boffetta P.Risk of second cancer among women with breast cancer.Int J Cancer2006;118:2285-92

[8] Brown LM,Pfeiffer RM,Hall P,Pukkala E,Kaijser M,Joensuu H,Travis LB.Risk of second non-hematological malignancies among 376,825 breast cancer survivors.Breast Cancer Res tr2007;106:439-51

[9] Tubiana M.Can we reduce the incidence of second primary malignancies occurring after radiotherapy? A critical review.Radiother Oncol2009;91:4-15

[10] Rubino C,Diallo I,Lê MG.Increased risk of second cancers following breast cancer: role of the initial treatment.Breast Cancer Res Treat2000;61:183-95

[11] Rubino C,Shamsaldin A,Lê MG.Radiation dose, chemotherapy, hormonal treatment and risk of second cancer after breast cancer treatment.Br J Cancer2003;89:840-6 PMCID:PMC2394476

[12] Zhang W,Biggeri A,Muirhead CR.Second malignancies in breast cancer patients following radiotherapy: a study in Florence, Italy.Breast Cancer Res2011;13:R38 PMCID:PMC3219201

[13] Zhang W,Biggeri A,Muirhead CR.Region of treatment in radiotherapy and second malignancies in breast cancer patients.J Cancer Therapy2012;3:768-76

[14] Donovan EM,Bonora M,Evans PM.Second cancer incidence risk estimates using BEIR VII models for standard and complex external beam radiotherapy for early breast cancer.Med Phys2012;39:5814-24 PMCID:PMC3498624

[15] Johansen S,Olsen DR.Estimated risk for secondary cancer in the contra-lateral breast following radiation therapy of breast cancer.Acta Oncol2008;47:391-6

[16] Niemierko A. (1999) A Generalized Concept of Equivalent Uniform Dose (EUD). Available from: http://www.scirp.org/(S(lz5mqp453edsnp55rrgjct55))/reference/ReferencesPapers.aspx?ReferenceID=1679390. [Last accessed on 30 Sep 2018]

[17] Niemierko A.Reporting and analyzing dose distributions: a concept of equivalent uniform dose.Med phys1997;24:103-10

[18] Webb S.A model for calculating tumour control probability in radiotherapy including the effects of inhomogeneous distributions of dose and clonogenic cell density.Phys Med Biol1993;38:653-66

[19] Schneider U,Ross D.Estimation of radiation-induced cancer from three-dimensional dose distributions: concept of organ equivalent dose.Int J Radiat Oncol Biol Phys2005;61:1510-5

[20] Abo-Madyan Y,Aly MM,Sperk E,Giordano FA,Steil V,Glatting G.Second cancer risk after 3D-CRT, IMRT and VMAT for breast cancer.Radiother Oncol2014;110:471-6

[21] Schneider U.A simple dose-response relationship for modeling secondary cancer incidence after radiotherapy.Z Med Phys2005;15:31-7

[22] Schneider U.Radiation risk estimates after radiotherapy: application of the organ equivalent dose concept to plateau dose-response relationships.Radiat Environ Biophys2005;44:235-9

[23] Burt LM,Poppe MM,Gaffney DK.Risk of secondary malignancies after radiation therapy for breast cancer: comprehensive results.Breast2017;35:122-9

[24] Berrington de Gonzalez A,Gilbert E,Smith SA,Ron E.Second solid cancers after radiotherapy for breast cancer in SEER cancer registries.Br J Cancer2010;102:220-6 PMCID:PMC2813734

[25] Maddams J,Darby SC.The cancer burden in the United Kingdom in 2007 due to radiotherapy.Int J Cancer2011;129:2885-93

[26] Morton LM,Hall P,Joensuu H,Dores GM,Holowaty EJ,Curtis RE,Kleinerman RA,Storm HH,Weathers RE,Rajaraman P,Brown LM,Fossa SD,Langmark F,Travis LB.Risk of treatment-related esophageal cancer among breast cancer survivors.Ann Oncol2012;23:3081-91 PMCID:PMC3501231

[27] Emadi A,Brodsky RA.Cyclophosphamide and cancer: golden anniversary.Nat Rev Clin Oncol2009;6:638-47

[28] Travis LB,Curtis RE,Andersson M,Joensuu T,van Leeuwen FE,Storm H,Pukkala E,Fraumeni JFJr,Gilbert E.Lung cancer following chemotherapy and radiotherapy for Hodgkin's disease.J Natl Cancer Inst2002;94:182-92

[29] Valagussa P,Terenziani M,Bonadonna G.Second malignancies following CMF-based adjuvant chemotherapy in resectable breast cancer.Ann Oncol1994;5:803-8

[30] Swerdlow AJ,Smith P,Hancock BW,Hoskin PJ,Radford JA,Linch DC.Second cancer risk after chemotherapy for Hodgkin's lymphoma: a collaborative British cohort study.J Clin Oncol2011;29:4096-104

[31] Corradini S,Weingandt H,Schönecker S,Simonetto C,Ganswindt U.Left-sided breast cancer and risks of secondary lung cancer and ischemic heart disease: effects of modern radiotherapy techniques.Strahlenther Onkol2018;194:196-205

[32] Darby SC,Taylor CW.Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries.Lancet Oncol2005;6:557-65

[33] Kirova YM,Gambotti L,Asselain B.Second malignancies after breast cancer: the impact of different treatment modalities.Br J Cancer2008;98:870-4 PMCID:PMC2266852

[34] Prochazka M,Ekbom A,Hall P.Lung cancer risks in women with previous breast cancer.Eur J Cancer2002;38:1520-5

[35] Neugut AI,Santos J,Hayes MK,Robinson E.Increased risk of lung cancer after breast cancer radiation therapy in cigarette smokers.Cancer1994;73:1615-20

[36] Inskip PD,Flannery JT.Lung cancer risk and radiation dose among women treated for breast cancer.J Natl Cancer Inst1994;86:983-8

[37] Grantzau T.Risk of second non-breast cancer after radiotherapy for breast cancer: a systematic review and meta-analysis of 762,468 patients.Radiother Oncol2015;114:56-65

[38] Nichols GP,Gibbons JP.Evaluation of volumetric modulated arc therapy for postmastectomy treatment.Radiat Oncol2014;9:66 PMCID:PMC3984750

[39] Obedian E,Haffty BG.Second malignancies after treatment of early-stage breast cancer: lumpectomy and radiation therapy versus mastectomy.J Clin Oncol2000;18:2406-12

[40] Travis LB,Allan JM,Kennedy AR,Purdy JA,Yahalom J,Gilbert ES.Second malignant neoplasms and cardiovascular disease following radiotherapy.J Natl Cancer Inst2012;104:357-70 PMCID:PMC3295744

[41] Hernandez M,Sanders M.A treatment planning comparison of volumetric modulated arc therapy and proton therapy for a sample of breast cancer patients treated with post-mastectomy radiotherapy.J Proton Ther2015;

[42] Boice JDJr,Blettner M,Flannery JT.Cancer in the contralateral breast after radiotherapy for breast cancer.N Engl J Med1992;326:781-5

[43] Evans HS,Robinson D,Møller H.Incidence of multiple primary cancers in a cohort of women diagnosed with breast cancer in southeast England.Br J Cancer2001;84:435-40 PMCID:PMC2363744

[44] Levi F,Randimbison L.Cancer risk in women with previous breast cancer.Ann Oncol2003;14:71-3

[45] Deutsch M,Begovic M,Wolmark N.The incidence of lung carcinoma after surgery for breast carcinoma with and without postoperative radiotherapy.Results of national surgical adjuvant breast and bowel project (NSABP) clinical trials B-04 and B-06. Cancer2003;98:1362-8