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Contralateral breast cancer higher among those with ATM gene mutations treated with radiation
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Women with unilateral breast cancer and ATM mutations who received radiation were at increased risk for developing contralateral breast cancer compared with women who did not have mutations and/or did not receive radiation.
Researchers analyzed data from women who participated in the Women’s Environment, Cancer, and Radiation Epidemiology Study. They included 708 women with contralateral breast cancer and 1,397 women with unilateral breast cancer matched for variables, including age and race.
Among women with rare ATM missense variants, those exposed to radiation levels ≥ 1 Gy had an elevated risk for second breast cancer vs. women with wild type ATM who did not receive radiation (rate ratio=2; 95% CI, 1.1-3.9).
Women with an ATM missense variants that were predicted to be deleterious were at an increased risk for contralateral breast cancer at both levels of radiation exposure vs. unexposed women with wild type ATM: The RR was 2.8 (95% CI, 1.2-6.5) for levels from 0.01 Gy to 0.99 Gy; for Gy ≥1, the RR was 3.3 (95% CI, 1.4-8).
Risk remained higher, even when compared with unexposed women with predicted deleterious missense variants: For radiation levels of 0.01 Gy to 0.99 Gy, the RR was 5.3 (95% CI, 1.6-17.3). For levels ≥1 Gy, the RR was 5.8 (95% CI, 1.8-19).
These findings re-emphasize the lack of understanding of the etiology of high long-term risk for contralateral breast cancers, according to David J. Brenner, PhD, professor of radiation biophysics, Columbia University Medical Cancer, N.Y.
“It is important, therefore, to continue to seek prophylactic preventative options that are useful for all breast cancer survivors,” he wrote in an accompanying editorial.
For more information:
- Bernstein JL. J Natl Cancer Inst. 2010;102:475-483.