Subsequent female breast cancer risk associated with anthracycline chemotherapy for childhood cancer

Analysis of pooled individual patient data from six studies investigated dose-dependent effects of anthracycline agents for childhood cancer on subsequent breast cancer (SBC) risk among female survivors. A dose-dependent increased SBC risk was seen for doxorubicin (HR per 100 mg/m² 1,24; 95% CI 1,18-1,31) with a more than twofold increased risk for survivors treated with ≥ 200 mg/m² cumulative doxorubicin dose versus no doxorubicin. For daunorubicin, the associations were nog statistically significant. Epirubicin was associated with increased SBC risk (yes versus no HR 3,25; 1.59-6.63). The authors conclude that early initiation of SBC surveillance may be reasonable for survivors who received ≥ 200 mg/m² doxorubicine dose.