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Risk of primary lung cancer after breast cancer radiotherapy: a systematic review and meta-analysis

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Abstract

Background

Epidemiological studies have shown that the risk of secondary malignancies may increase by radiotherapy. Lung cancer is the most important long-term complication of breast cancer radiotherapy.

Methods

Major electronic databases including Scopus, Web of Science, and MEDLINE were searched. All cohort studies that investigated the association between radiotherapy for breast cancer and risk of primary lung, bronchus, and trachea cancers conducted until March 2021 were included. The study participants were evaluated regardless of their age and ethnicity. The Newcastle–Ottawa Scale was used to assess the quality of the studies. The designated effects were risk ratio (RR). The random-effects model was used to estimate the average effects.

Results

Fifteen studies including 1,640,247 women with primary breast cancer were identified of which 937,151 had not received radiotherapy and 703,096 subjects had received radiotherapy. In general, there was no significant association between breast cancer radiotherapy and lung cancer based on 10 studies (RR = 0.95, 95% CI 0.87–1.02, P = 0.15), There was no association between breast cancer radiotherapy and lung, bronchus, and trachea cancers either based on 5 studies (RR = 0.98, 95% CI 0.93–1.02, P = 0.32).

Conclusion

Radiotherapy for breast cancer is not associated with an excess risk of lung cancer. Due to the limited number of studies, lack of data regarding smoking status, and substantial variation in exposure of the lungs in breast cancer radiotherapy worldwide, further investigations based on randomized controlled trials are suggested to address the potential risk of lung cancer after breast cancer radiotherapy.

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Funding

This work was supported by the Vice-Chancellor of Research and Technology, Hamadan University of Medical Sciences. The supporter had no role in study design, data collection, analysis, interpretation, or writing of the report.

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Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, Hamadan University of Medical Science, Hamadan, Iran

    Bushra Zareie & Jalal Poorolajal

  2. Clinical Research Development Unit, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran

    Mohammad Aziz Rasouli

  3. Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

    Jalal Poorolajal

Authors
  1. Bushra Zareie
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Correspondence to Jalal Poorolajal.

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Zareie, B., Rasouli, M.A. & Poorolajal, J. Risk of primary lung cancer after breast cancer radiotherapy: a systematic review and meta-analysis. Breast Cancer 29, 361–367 (2022). https://doi.org/10.1007/s12282-021-01318-w

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  • DOI: https://doi.org/10.1007/s12282-021-01318-w

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