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Risk of primary lung cancer after adjuvant radiotherapy in breast cancer—a large population-based study

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Anna Karin Wennstig, Charlotta Wadsten, Hans Garmo, Mikael Johansson, Irma Fredriksson, Carl Blomqvist, Lars Holmberg, Greger Nilsson, Malin Sund

Original languageEnglish
Article number71
Journalnpj Breast Cancer
Issue number1
PublishedDec 2021

Bibliographical note

Funding Information: This work was supported by grants from the Swedish Breast Cancer Association; Visare Norr grant (Grant no: 750491); The Department of Research and Development Västernorrland County Council (Grant no: LVNFOU834391); and The Percy Falk Foundation for medical research. The funding body had no part in the design of the study, collection, analysis, and interpretation of data, or in writing the manuscript. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Adjuvant radiotherapy (RT) for breast cancer (BC) has been associated with an increased risk of later radiation-induced lung cancer (LC). We examined the risk of primary LC in a population-based cohort of 52300 women treated for BC during 1992 to 2012, and 253796 age-matched women without BC. Cumulative incidence of LC was calculated by the Kaplan–Meier method, and the risk of LC after BC treatment was estimated by Cox proportional hazards regression analyses. Women with BC receiving RT had a higher cumulative incidence of LC compared to women with BC not receiving RT and women without BC. This became apparent 5 years after RT and increased with longer follow-up. Women with BC receiving RT had a Hazard ratio of 1.59 (95% confidence interval 1.37–1.84) for LC compared to women without BC. RT techniques that lower the incidental lung doses, e.g breathing adaption techniques, may lower this risk.

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