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Risk of Radiation-Associated Contralateral Breast Cancer in Germline Mutation Carriers: A Meta-Analysis and
Christina Hari Nawangsih Prihharsanti1, Yan Wisnu Prajoko2, Danendra Rakha Putra Respati3
1Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Universitas Diponegoro, Semarang 50275, Indonesia.
Radiotherapy significantly increases the risk of contralateral breast cancer (CBC) in survivors with BRCA1/2, ATM, and CHEK2 gene mutations. This finding highlights the need for personalized treatment strategies based on genetic risk.
Area of Science:
- Oncology
- Genetics
- Radiation Oncology
Background:
- Contralateral breast cancer (CBC) is a concern for breast cancer survivors, especially those with high-penetrance germline mutations.
- The role of radiotherapy (RT) in increasing CBC risk among these individuals is not well understood.
Purpose of the Study:
- To systematically review and meta-analyze the incidence of radiation-induced CBC in germline mutation carriers.
- To evaluate the association between RT and CBC risk in BRCA1, BRCA2, CHEK2, and ATM mutation carriers.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Searched six databases for cohort and case-control studies published within the last 15 years.
- Utilized a random-effects model to estimate cumulative risk (CR) and rate ratios (RR).
Main Results:
- Seven studies were included in the analysis.
- Five-year CR of CBC was 0.55 for BRCA1/2, 0.89 for ATM, and 0.80 for CHEK2 carriers.
- Radiotherapy showed a significant RR of 2.98 for ATM carriers and an overall RR of 2.53, indicating a >2-fold increased CBC risk.
Conclusions:
- Radiotherapy significantly elevates the risk of contralateral breast cancer.
- ATM and CHEK2 mutation carriers are particularly susceptible to radiation-induced CBC.
- Personalized genetic risk stratification is crucial for optimizing breast cancer treatment decisions.
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