Showing papers by "Henning T. Mouridsen published in 1992"
TL;DR: In this article, the axillary nodal status at the primary operation for breast cancer was evaluated in 13,851 patients registered by the Danish Breast Cancer Cooperative Group (DBCG).
262 citations
TL;DR: There was no evidence that risk varied with radiation dose, time since exposure, or age at exposure, and the second tumors in case patients were evenly distributed in the medial, lateral, and central portions of the breast, a finding that argues against a causal role of radiotherapy in tumorigenesis.
Abstract: BACKGROUND The risk of contralateral breast cancer is increased twofold to fivefold for breast cancer patients A registry-based cohort study in Denmark suggested that radiation treatment of the first breast cancer might increase the risk for contralateral breast cancer among 10-year survivors PURPOSE Our goal was to assess the role of radiation in the development of contralateral breast cancer METHODS A nested case-control study was conducted in a cohort of 56,540 women in Denmark diagnosed with invasive breast cancer from 1943 through 1978 Case patients were 529 women who developed contralateral breast cancer 8 or more years after first diagnosis Controls were women with breast cancer who did not develop contralateral breast cancer One control was matched to each case patient on the basis of age, calendar year of initial breast cancer diagnosis, and survival time Radiation dose to the contralateral breast was estimated for each patient on the basis of radiation measurements and abstracted treatment information The anatomical position of each breast cancer was also abstracted from medical records RESULTS Radiotherapy had been administered to 824% of case patients and controls, and the mean radiation dose to the contralateral breast was estimated to be 251 Gy Radiotherapy did not increase the overall risk of contralateral breast cancer (relative risk = 104; 95% confidence interval = 074-146), and there was no evidence that risk varied with radiation dose, time since exposure, or age at exposure The second tumors in case patients were evenly distributed in the medial, lateral, and central portions of the breast, a finding that argues against a causal role of radiotherapy in tumorigenesis CONCLUSIONS The majority of women in our series were perimenopausal or postmenopausal (53% total versus 38% premenopausal and 9% of unknown status) and received radiotherapy at an age when the breast tissue appears least susceptible to the carcinogenic effects of radiation Based on a dose of 251 Gy and estimates of radiation risk from other studies, a relative risk of only 118 would have been expected for a population of women exposed at an average age of 51 years Thus, our data provide additional evidence that there is little if any risk of radiation-induced breast cancer associated with exposure of breast tissue to low-dose radiation (eg, from mammographic x rays or adjuvant radiotherapy) in later life
139 citations
TL;DR: With a median follow-up of 8 years, the incidence of tumours in the contralateral breast was similar among tamoxifen-treated, and non-treated high-risk patients even after adjusting for tumours arising within the first year.
Abstract: The occurrence of new primary tumours among postmenopausal patients with primary breast cancer subsequent to adjuvant treatment in Denmark was assessed by linkage to the cancer registry. Following primary surgery, patients in low risk of recurrence (n = 1,828) received no further treatment while patients in high risk randomly received either adjuvant radiotherapy alone (n = 846) or radiotherapy + tamoxifen 30 mg daily for 48 weeks (n = 864). With a median follow-up of 8 years, the incidence of tumours in the contralateral breast was similar among tamoxifen-treated, and non-treated high-risk patients even after adjusting for tumours arising within the first year. The standardized incidence ratio for endometrial cancer was 1.9 (95% confidence interval 0.8-3.9) among tamoxifen treated, the cumulative incidence 1% compared to 0.3% among non-treated patients (p = 0.11). The cumulative risk of non-lymphocytic leukaemia was 0.9% and 0.1% among irradiated and non-irradiated patients respectively (p = 0.4). Prolonged follow-up of tamoxifen-treated patients with regard to new tumours is recommended.
65 citations
TL;DR: The majority of trials have not demonstrated significant differences in distribution of metastases in patients receiving different types of adjuvant systemic therapy, and the available data on the rate of response showed higher response rates in soft tissue metastases, compared to visceral and bone metastases.
Abstract: The efficacy of cytotoxic therapy in different anatomical sites can be studied by analyzing the anatomical distribution of recurrences following adjuvant therapy or the rate of response according to site of metastasis Cumulated data from 7 adjuvant studies showed that the relative reduction in the rate of recurrence was 37% for local and regional recurrences versus 25% for distant metastases There are only sparse and inconclusive data concerning the anatomical pattern of recurrence according to type of adjuvant chemotherapy Thus, the majority of trials have not demonstrated significant differences in distribution of metastases in patients receiving different types of adjuvant systemic therapy The available data on the rate of response in relation to metastatic site showed higher response rates in soft tissue metastases (55%), compared to visceral and bone metastases (40%) Cumulated data from 12 trials showed no differences in response rates between different soft tissue lesions (skin, subcutaneous ti
6 citations