ESTRO Multidisciplinary Management of Breast Cancer 2017

Effect of Radiotherapy on Non-breast-cancer Mortality and on Incidence of Second Cancers before any Recurrence of Breast Cancer (40,781 women in 75 trials of radiotherapy versus no radiotherapy)

Number of events

Rate ratio (95% CI)

P value

RT Excess with RT Death without breast cancer recurrence No RT

Heart disease

705 475 638

548 375 629

143

1.30 (1.15—1.46) 1.19 (1.03—1.37) 1.01 (0.90—1.14)

<0.0001

Non-breast cancer

67

0.02 0.83

Other specified causes

6

Second cancer incidence without prior breast cancer recurrence

Leukaemia

43

23 60 40 10

17

1.71 (1.05—2.79) 1.08 (0.76—1.53) 2.10 (1.48—2.98) 2.42 (1.19—4.92)

0.03 0.66

Lung, years 0-9 Lung, years 10+

71

5

94 23

47 13

<0.0001

Oesophagus

0.01

Contralateral breast

881 673

130

1.20 (1.08—1.33)

0.0006

Taylor et al on behalf of EBCTCG, JCO 2017; 35:1641