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Mutation, Plus Radiation, May Cause Second Breast Cancer

March 25, 2010
Written by: , Filed in: Breast Imaging, Nuclear Medicine
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Part 1 of 2 on gene mutations and radiation:

Women with rare mutations in the ataxia telangiectasia mutated (ATM) gene and who undergo radiation treatments for cancer in one breast have an increased chance of developing cancer in the other breast. The gene has already been linked to DNA damage after ionizing radiation.

The results, in an article in Medical News Today, were from the international case-control Women’s Environment, Cancer, and Radiation Epidemiology (WECARE) Study, conducted by Jonine Bernstein, MD, and her colleagues from the Memorial Sloan-Kettering Cancer Center in New York. They did full mutation screening of the ATM gene on all participants and estimated, from treatment records, the amount of radiation that had reached the contralateral breast in each patient. They compared mutations in women with cancer in only one breast to those in women with cancer that had spread to the second breast. Control subjects, without a second cancer but similar to the case subjects in age and race and other characteristics, numbered 1,397. There were 708 case subjects, with contralateral cancer.

The mutations, missense variants predicted to be deleterious, were found in less than 1% of the participants. Those who had them, however, and who had gotten radiation treatments had an increased risk of having a second breast affected, much more so than women without the mutations and who had not had radiation. They, as well, had a significantly higher risk than those women who did have the mutations but who had had no radiation.

In response to the information, David Brenner, PhD, of the Columbia University Medical Center in New York, suggested “prophylactic irradiation of the contralateral breast, using doses too low to cause tumors but sufficient to kill premalignant cells,” according to the article. “The WECARE results, he writes, ‘reemphasizes that we do not yet understand most of the etiology of the disturbingly high long-term risks of second breast cancers. It is important, therefore, to continue to seek prophylactic preventative options that are useful for all breast cancer survivors.'”

Related seminar: Breast & Women’s Imaging Seminar

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