Treatment, toxicity, and mortality after subsequent breast cancer in female survivors of childhood cancer

被引：1

作者：

Im, Cindy ^{[1
]}

Hasan, Hasibul ^{[1
]}

Stene, Emily ^{[1
]}

Monick, Sarah ^{[2
]}

Rader, Ryan K. ^{[3
]}

Sheade, Jori ^{[4
]}

Wolfe, Heather ^{[5
]}

Lu, Zhanni ^{[1
]}

Spector, Logan G. ^{[1
]}

Mcdonald, Aaron J.

Nolan, Vikki ^{[6
]}

Arnold, Michael A. ^{[7
,8
]}

Conces, Miriam R. ^{[9
]}

Moskowitz, Chaya S. ^{[10
]}

Henderson, Tara O. ^{[11
]}

Robison, Leslie L. ^{[6
]}

Armstrong, Gregory T. ^{[6
]}

Yasui, Yutaka ^{[6
]}

Nanda, Rita ^{[12
]}

Oeffinger, Kevin C. ^{[13
]}

Neglia, Joseph P. ^{[1
]}

Blaes, Anne ^{[14
]}

Turcotte, Lucie M. ^{[1
]}

机构：

[1] Univ Minnesota, Dept Pediat, Minneapolis, MN 55455 USA

[2] Mayo Clin Arizona, Dept Hematol Oncol, Phoenix, AZ 85054 USA

[3] Univ Kansas, Dept Med, Westwood, KS 66205 USA

[4] Northwestern Med Lake Forest Hosp, Lurie Canc Ctr Affiliate Network, Dept Hematol Oncol, Lake Forest, IL 60045 USA

[5] Univ Texas Southwestern Med Ctr Dallas, Dept Med, Dallas, TX 75390 USA

[6] St Jude Childrens Res Hosp, Dept Epidemiol & Canc Control, Memphis, TN 38105 USA

[7] Univ Colorado, Childrens Hosp Colorado, Dept Pathol & Lab Med, Anschutz Med Campus, Aurora, CO 80045 USA

[8] Univ Colorado, Dept Pathol, Anschutz Med Campus, Aurora, CO 80045 USA

[9] Nationwide Childrens Hosp, Dept Pathol & Lab Med, Columbus, OH 43205 USA

[10] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10017 USA

[11] Univ Chicago, Dept Pediat, Chicago, IL 60637 USA

[12] Univ Chicago, Dept Med, Chicago, IL 60637 USA

[13] Duke Univ, Dept Med, Durham, NC 27705 USA

[14] Univ Minnesota, Dept Med, Minneapolis, MN 55455 USA

来源：

NATURE COMMUNICATIONS | 2025年 / 16卷 / 01期

关键词：

HODGKINS LYMPHOMA; 5-YEAR SURVIVORS; HEART-FAILURE; RISK; RADIATION; THERAPY; CHEMOTHERAPY; DEXRAZOXANE; PREDICTION; MANAGEMENT;

D O I：

10.1038/s41467-025-58434-w

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Childhood cancer survivors, particularly those who received chest radiotherapy, are at high risk for developing subsequent breast cancer. Minimizing long-term toxicity risks associated with additional radiotherapy and chemotherapy is a priority, but therapeutic tradeoffs have not been comprehensively characterized and their impact on survival is unknown. In this study, 431 female childhood cancer survivors with subsequent breast cancer from a multicenter retrospective cohort study were evaluated. Compared with one-to-one matched females with first primary breast cancer, survivors are as likely to be prescribed guideline-concordant treatment (N = 344 pairs; survivors: 94%, controls: 93%), but more frequently undergo mastectomy (survivors: 81%, controls: 60%) and are less likely to be treated with anthracyclines (survivors: 47%, controls: 66%) or radiotherapy (survivors: 18%, controls: 61%). Despite this, survivors have nearly 3.5-fold (95% CI = 2.17-5.57) greater mortality risk. Here, we show survivors with subsequent breast cancer face excess mortality despite therapeutic tradeoffs and require specialized treatment guidelines.

引用

页数：11

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