for those considering accelerated partial breast irradiation
 

this article shows increased risk of second cancers particularly in areas which may be affected by standard radiation therapy ie, esophagus, nonHodgkin's lymphoma (perhaps due to radiation of the thymus gland) etc.

APBI radiates only the excision cavity rather than the whole breast and thus is associated with a lower dose to "innocent bystander" adjacent tissue

Full Paper



British Journal of Cancer advance online publication 3 October 2006; doi:10.1038/sj.bjc.6603404 www.bjcancer.com

Family history of breast cancer and young age at diagnosis of breast cancer increase risk of second primary malignancies in women: a population-based cohort study

M Prochazka1, P Hall1, F Granath2 and K Czene1

1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77 Stockholm, Sweden

2Department of Medicine at Karolinska University Hospital, Clinical Epidemiology Unit, SE-171 76 Stockholm, Sweden



Correspondence to: Dr M Prochazka, E-mail: Michaela.Prochazka@ki.se

Received 10 July 2006; revised 23 August 2006; accepted 6 September 2006; published online 3 October 2006



Among 152 600 breast cancer patients diagnosed during 1958-2000, there was a 22% increased risk of developing a second primary non-breast malignancy (standardised incidence ratio (SIR)=1.22; 95% confidence interval (CI): 1.19-1.24). The highest risk was seen for connective tissue cancer (SIR=1.78; 95% CI: 1.49-2.10). Increased risks were noted among women diagnosed with breast cancer before age 50. Oesophagus cancer and non-Hodgkin's lymphoma showed six- and four-fold higher risks, respectively, in women with a family history of breast cancer compared to those without in the 10-year follow-up period.

Lani, I am actually a participant in a clincial trial for whole vs. partial breast irradiation. Unfortunately, I was randomized to the whole breast arm. I believe this is another area where we will find that "less is more."

Hopeful