McPherson et al note that the breast tissue of the young is
particularly sensitive to radiation carcinogenesis. (1) Their diagram
demonstrates the increased cumulative lifetime risk of breast cancer in
women who were A-bomb survivors as teenagers. (1) More commonly seen in
practice than A-bomb survivors, are women treated for Hodgkin’s disease as
children or adolescents. One series examining this group demonstrated a
cumulative probability of breast cancer by 40 years of age of 35%. (2)
Fortunately the risk of radiation induced cancers falls sharply with the
age at exposure - the risk from radiation scattered to the contralateral
breast when treating breast cancer or DCIS is small indeed. (3) Similarly
this explains why the benefits of mammography outweigh radiation
carcinogenesis in the appropriate age groups.
Sean Bydder, Registrar. s_bydder@hotmail.com
Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands
Western Australia Australia WA 6008
(1) McPherson K, Steel, CM. Dixon JM. Breast cancer – epidemiology,
risk factors and genetics. BMJ 2000; 321:624-628.
(2) Joseph DJ, Spry N, Bydder S. Adjuvant radiotherapy for DCIS.
Lancet. 2000;355:2072.
(3) Bhatia S, Robison LL, Oberlin O, Greenberg M, Bunin G, Fossati-
Bellani F, Meadows AT Breast cancer and other second neoplasms after
childhood Hodgkin's disease.
N Engl J Med 1996;334:745-51.
Competing interests:
No competing interests
11 September 2000
Sean Bydder
Registrar
Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
Rapid Response:
Age, radiation and breast cancer.
TO THE EDITOR:
McPherson et al note that the breast tissue of the young is
particularly sensitive to radiation carcinogenesis. (1) Their diagram
demonstrates the increased cumulative lifetime risk of breast cancer in
women who were A-bomb survivors as teenagers. (1) More commonly seen in
practice than A-bomb survivors, are women treated for Hodgkin’s disease as
children or adolescents. One series examining this group demonstrated a
cumulative probability of breast cancer by 40 years of age of 35%. (2)
Fortunately the risk of radiation induced cancers falls sharply with the
age at exposure - the risk from radiation scattered to the contralateral
breast when treating breast cancer or DCIS is small indeed. (3) Similarly
this explains why the benefits of mammography outweigh radiation
carcinogenesis in the appropriate age groups.
Sean Bydder, Registrar.
s_bydder@hotmail.com
Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands
Western Australia Australia WA 6008
(1) McPherson K, Steel, CM. Dixon JM. Breast cancer – epidemiology,
risk factors and genetics. BMJ 2000; 321:624-628.
(2) Joseph DJ, Spry N, Bydder S. Adjuvant radiotherapy for DCIS.
Lancet. 2000;355:2072.
(3) Bhatia S, Robison LL, Oberlin O, Greenberg M, Bunin G, Fossati-
Bellani F, Meadows AT Breast cancer and other second neoplasms after
childhood Hodgkin's disease.
N Engl J Med 1996;334:745-51.
Competing interests: No competing interests