原发性乳腺癌和甲状腺癌并存的风险。

The risk of multiple primary breast and thyroid carcinomas.

作者信息

Adjadj Elisabeth, Rubino Carole, Shamsaldim Akhtar, Lê Monique G, Schlumberger Martin, de Vathaire Florent

机构信息

Unit of Cancer Epidemiology, National Institute of Health and Medical Research, Gustave Roussy Institute, Villejuif, France.

出版信息

Cancer. 2003 Sep 15;98(6):1309-17. doi: 10.1002/cncr.11626.

DOI:10.1002/cncr.11626

PMID:12973856

Abstract

BACKGROUND

Some studies have suggested that there is an association between breast carcinoma and thyroid carcinoma. Because ionizing radiation is a well known risk factor for breast and thyroid carcinomas, the authors studied the effect of the radiation dose delivered for the treatment of each of these two malignancies on the risk of subsequently developing the other malignancy.

METHODS

The risk of developing thyroid carcinoma subsequent to treatment for breast carcinoma was analyzed in 8 patients (cases) and 192 matched control patients (controls) nested in a cohort of 7711 women who were treated at Institut Gustave Roussy between 1954 and 1983. The risk of developing breast carcinoma after treatment for thyroid carcinoma was studied in a cohort of 2365 women who were treated in 3 French cancer centers between 1934 and 1995.

RESULTS

Six of 8 patients with breast carcinoma (75%) who developed thyroid carcinoma and 71% of patients in the control group received radiation therapy during their treatment. The median dose to the thyroid was 6.6 grays (Gy) in the case group and 9.4 Gy in the control group. The overall relative risk of thyroid carcinoma associated with radiation therapy was 1.2 (95% confidence interval, 0.2-6.2). No relation was observed between the radiation dose and the risk of thyroid carcinoma (P = 0.8). Among 2365 women who were treated for thyroid carcinoma, 48 women developed a subsequent breast carcinoma. A significant excess of breast carcinoma was observed among women younger than 59 years at the time of diagnosis of breast carcinoma compared with women in the same age group in the general population. The mean absorbed dose delivered to the breasts by (131)I and external radiation therapy was 0.7 Gy. No relation was found between the radiation dose and the risk of breast carcinoma (P = 0.8).

CONCLUSIONS

The previously reported excess incidence of breast carcinoma after thyroid carcinoma was not related to radiation treatment with (131)I and/or external radiation therapy. Radiation therapy for breast carcinoma did not increase the risk of subsequent thyroid carcinoma.

摘要

背景

一些研究表明乳腺癌与甲状腺癌之间存在关联。由于电离辐射是乳腺癌和甲状腺癌众所周知的危险因素，作者研究了针对这两种恶性肿瘤各自进行治疗时所给予的辐射剂量对随后发生另一种恶性肿瘤风险的影响。

方法

在1954年至1983年于古斯塔夫·鲁西研究所接受治疗的7711名女性队列中，对8例乳腺癌治疗后发生甲状腺癌的患者（病例组）和192例匹配的对照患者（对照组）进行分析，以评估乳腺癌治疗后发生甲状腺癌的风险。在1934年至1995年期间于3个法国癌症中心接受治疗的2365名女性队列中，研究甲状腺癌治疗后发生乳腺癌的风险。

结果

8例发生甲状腺癌的乳腺癌患者中有6例（75%）以及对照组中71%的患者在治疗期间接受了放射治疗。病例组甲状腺的中位辐射剂量为6.6戈瑞（Gy），对照组为9.4 Gy。与放射治疗相关的甲状腺癌总体相对风险为1.2（95%置信区间，0.2 - 6.2）。未观察到辐射剂量与甲状腺癌风险之间的关系（P = 0.8）。在2365例接受甲状腺癌治疗的女性中，有48例随后发生了乳腺癌。与一般人群中同年龄组女性相比，在乳腺癌诊断时年龄小于59岁的女性中观察到乳腺癌显著增多。碘 - 131和外照射放疗给予乳房的平均吸收剂量为0.7 Gy。未发现辐射剂量与乳腺癌风险之间的关系（P = 0.8）。