J Breast Cancer.  2019 Sep;22(3):464-471. 10.4048/jbc.2019.22.e42.

Gastric Complications after Adjuvant Radiotherapy for Breast Cancer

• Cho WK
• Choi DH
• Park W
• Kim H
• Kim S
• Shin MH
• Cha H

• KMID: 2458866
• DOI: http://doi.org/10.4048/jbc.2019.22.e42

Abstract

PURPOSE
In some patients who receive adjuvant radiotherapy (RT) for the left breast, the stomach is located inside the RT field. This study investigates the incidence of gastric complications following adjuvant RT for breast cancer using data of the Health Insurance Review and Assessment Service in South Korea.
METHODS
We identified 37,966 women who underwent surgery and received adjuvant RT for breast cancer. The cumulative incidence rate of gastric hemorrhage and gastric cancer was calculated and compared for left and right breast cancers.
RESULTS
Among 37,966 patients, 19,531 (51.4%) and 18,435 (48.6%) had right and left breast cancers, respectively. After a median follow-up duration of 6.3 years, the cumulative incidence of gastric cancer and gastric hemorrhage did not differ between right and left breast cancers (p = 0.414 and p = 0.166, respectively). The multivariable analysis revealed that old age was the only factor associated with the development of gastric cancer (p < 0.001) and gastric hemorrhage (p < 0.001). The incidence of gastric cancer and hemorrhage did not differ between patients who received adjuvant RT for right and left breast cancers.
CONCLUSION
Irradiation-related chronic complications of the stomach in patients with breast cancer are minimal. A study with a longer follow-up duration might be needed to assess the risk of gastric cancer.

Keyword

Breast neoplasms; Gastrointestinal hemorrhage; Radiotherapy; Stomach neoplasms

MeSH Terms

Breast Neoplasms*
Breast*
Female
Follow-Up Studies
Gastrointestinal Hemorrhage
Hemorrhage
Humans
Incidence
Insurance, Health
Korea
Radiotherapy
Radiotherapy, Adjuvant*
Stomach
Stomach Neoplasms

Figure

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  Figure 1 Flowchart of the patient selection process. RT = radiotherapy.

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  Figure 2 Cumulative incidence of gastric cancer in (A) women with right and left breast cancers and (B) women aged ≤ 40, 41–50, 51–60, and > 60 years. HR = hazard ratio; CI = confidence interval.

• 

  Figure 3 Cumulative incidence of hemorrhagic gastric disease in (A) women with right and left breast cancers and (B) women aged ≤ 40, 41–50, 51–60, and > 60 years. HR = hazard ratio; CI = confidence interval.

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