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Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Cancer 2014 ; 120 (23): 3722-30 Nephropedia Template TP
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Breast Cancer in Female Wilms Tumor Survivors: A Report from the National Wilms Tumor Late Effects Study #MMPMID25348097
Lange JM; Takashima JR; Peterson SM; Kalapurakal JA; Green DM; Breslow NE
Cancer 2014[Dec]; 120 (23): 3722-30 PMID25348097show ga
Background: Standard treatment of pulmonary metastasis in patients with Wilms tumor (WT) includes 12 Gy radiation therapy (RT) to the entire chest. The risk of breast cancer (BC) in a large cohort of female survivors of WT has not previously been reported. Methods: 2,492 female participants in National Wilms Tumor Studies 1?4 (1969?1995) were followed from age 15 through mid 2013 for incident BC. Median age at last contact was 27.3 years. We calculated cumulative risk at age 40 (CR40), hazard ratios (HR) by Cox regression, standardized incidence ratios (SIR) relative to US population rates and [shown in brackets] 95% confidence intervals. Results: Numbers of survivors with invasive BC divided by numbers at risk were 16/369 (CR40=14.8% [8.7?24.5]) for women who received chest RT for metastatic WT, 10/894 (CR40=3.1% [1.3?7.41]) for those who received only abdominal RT and 2/1,229 (CR40=0.3% [0.0?2.3]) for those who received no RT. The SIRs for these three groups were 27.6 [16.1?44.2] based on 5,010 person-years (PY) of follow-up, 6.0 [2.9,11.0] based on 13,185 PY, and 2.2 [0.3,7.8] based on 13,560 PY, respectively. The risk was high regardless of chest RT among women diagnosed with WT at age 10 or later, with 9/90 developing BC (CR40=13.5% [5.6?30.6], SIR=23.6 [10.8?44.8], PY=1,463). Conclusion: Female WT survivors treated with chest RT had high risk of early BC, with nearly 15% developing invasive disease by age 40. Current guidelines that recommend screening only survivors receiving ?20 Gy RT to the chest might be re-evaluated.