Radiation-induced second malignancies (RISM) is one of the important late side effects of radiation therapy and has an impact on optimal treatment decision-making. Many factors contribute to the development of RISM such as age at radiation, dose and volume of irradiated area, type of irradiated organ and tissue, radiation technique and individual and family history of cancer. Exact mechanism of RISM is unknown. But nowadays, it is a growing concern in oncology because of the increased number of cancer survivors and efforts are being made to prevent or decrease the incidence of RISM. The primary search for articles was carried via Google Scholar and PubMed with keywords included ‘radiation induced malignancies, second malignancies, and chemotherapy induced malignancies’. Additional papers were found through references from relevant articles. In this review article, we have discussed about the pathogenesis, factors contributing to RISM, screening and prevention strategies of RISM.

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Introduction -Triple Negative Breast Cancer (TNBC) is a type of breast cancer which is characterized by its unique molecular profile of ER, PR and HER2Neu Negativity. They are generally aggressive in nature, present with different metastatic patterns and there are no targeted therapies till date. It constitutes 15-20% of all breast carcinomas. To identify the clinical behaviour of TNBC, we evaluated the 62 patients of TNBC presenting in our department in last 3 years. Methods:-Patients diagnosed with breast carcinoma (tissue diagnosis) presenting to our institution were evaluated for their ER, PR and HER2Neu status. Triple Negative (ER Negative, PR Negative, HER2Neu Negative) breast cancer subtype patients were given treatment according to the stage and patient preferences. Operable patients willing for mastectomy were operated followed by adjuvant treatment while inoperable patients were given Neo-adjuvant chemotherapy followed by surgery +/-radiotherapy. Results:-Median age of patients was 45 years (range 28-81). Majority of patients were locally advanced (82.3%) and 79% had positive nodes at the time of presentation. Initial metastasis in the cohort was around 24.2% despite most tumours being locally advanced. Bone and Liver was the most common site of metastasis at diagnosis. Upfront surgery was done in 35.48% patients while 64.52% patients were started on chemotherapy out of which 62.5% patients were amenable to surgery. At a median follow up of 23 months local recurrence was seen in 9.7% and distant metastasis in 40.32% of cases. Most common site of distant metastasis was Brain (14.52%) followed by Liver (11.29%) and Lung (11. 29%).The median disease free survival (DFS) and time to local failure in the study was 11 and 12.5 months respectively. Conclusion:-TNBCs present in younger women show variable response to chemotherapy and carry the worse prognosis, having high recurrence rate.