Chest X-rays & Risk of BCa: BRCA1/2 Mutations Carriers

Effect of Chest X-Rays on the Risk of Breast Cancer Among BRCA1/2 Mutation Carriers in the International BRCA1/2 Carrier Cohort Study.

Andrieu N, Easton DF, Chang-Claude J, Rookus MA, Brohet R, Cardis E, Antoniou AC, Wagner T, Simard J, Evans G, Peock S, Fricker JP, Nogues C, Van't Veer L, Van Leeuwen FE, Goldgar DE.

L'Institut National de la Sante et de la Recherche Medicale Emi00-06 et Service de Biostatistique de l'Institut Curie, Paris; International Agency for Research on Cancer, Lyon; Centre Paul Strauss, Strasbourg; Centre Rene Huguenin, Saint Cloud, France; Cancer Research UK, Genetic Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge; Department of Genetics, St Mary's Hospital, Manchester, United Kingdom; Division of Clinical Epidemiology, German Cancer Research Center, Heidelberg, Germany; Departments of Epidemiology and Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Division of Senology, Medical University of Vienna and Private Trust for Breast Health, Vienna, Austria; Laboratoire de Genomique des Cancers, Laval University, Quebec City, Quebec, Canada; and Department of Medical Informatics, University of Utah, Salt Lake City, UT; and the Gene Etude Prospective Sein Ovaire (GENEPSO), Gen en Omgeving studie van de werkgroep Hereditiair Borstkanker Onderzoek Nederland (GEO-HEBON), and the International BRCA1/2 Carrier Cohort Study (IBCCS) Collaborators' Group.

PURPOSE: Women who carry germline mutations in the BRCA1 and BRCA2 genes are at greatly increased risk of breast cancer (BC). Numerous studies have shown that moderate to high doses of ionizing radiation are a risk factor for BC. Because of the role of the BRCA proteins in DNA repair, we hypothesized that BRCA carriers might be more sensitive to ionizing radiation than women in the general population.

PATIENTS AND METHODS: A retrospective cohort study of 1,601 female BRCA1/2 carriers was performed. Risk of breast cancer from exposure to chest x-rays, as assessed by questionnaire data, was analyzed using a weighted Cox proportional hazards model.

RESULTS: In this cohort, any reported exposure to chest x-rays was associated with an increased risk of BC (hazard ratio [HR] = 1.54; P = .007).

This risk was increased in carrier women aged 40 years and younger (HR = 1.97; P < .001) and in women born after 1949 (HR = 2.56; P < .001), particularly those exposed only before the age of 20 years (HR = 4.64; P < .001).

CONCLUSION: In our series of BRCA carriers, we detected a relatively large effect on BC risk with a level of radiation exposure that is at least an order of magnitude lower than in previously studied medical radiation-exposed cohorts.

Although part of this increase may be attributable to recall bias, the observed patterns of risk in terms of age at exposure and attained age are consistent with those found in previous studies.

If confirmed, the results have important implications for the use of x-ray imaging in young BRCA1/2 carriers.

J Clin Oncol. 2006 Jun 26; [Epub ahead of print]

Remember we are NOT Doctors and have NO medical training.

This site is like an Encyclopedia - there are many pages, many links on many topics.

Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.