Incidence of interstitial pneumonitis among breast cancer patients: a 10-year Danish population-based cohort study

Christensen, Steffen; Pedersen, Lars; Grijota, Miriam; Kornum, Jette Brommann; Beiderbeck, Annette B.; Sørensen, Henrik Toft

doi:10.1038/sj.bjc.6604393

Cited by 11 publications

(6 citation statements)

References 20 publications

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“…The validity of our findings depends ultimately on the accuracy of ILD coding, including levels of diagnostic work-up, and completeness of reporting in the Danish National Registry of Patients. A previous examination of the validity of diagnoses of interstitial lung diseases caused by external agents in the Danish National Registry of Patients yielded high positive predictive values of 92% (95% CI: 73%–98%) for drug induced ILDs and 87% (95% CI: 59%–98%) for radiation induced ILDs, compared with other discharge diagnoses [ 12 , 13 ]. The ICD-10 codes used to identify cases in this study do not correspond completely to the new classification recently developed for ILDs [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

The incidence of interstitial lung disease 1995–2005: a Danish nationwide population-based study

et al. 2008

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BackgroundCurrent data on incidence of interstitial lung diseases (ILDs) are sparse and concerns about an increasing trend have been raised. We examined incidence rates (IRs) of ILDs and changes in IRs between 1995 and 2005.MethodsAll persons with a first-time hospital discharge or outpatient diagnosis of ILD were identified through the Danish National Registry of Patients, which covers all Danish hospitals. Crude and age-standardised IRs were computed for ILD overall, as well as stratified by ILD subcategories.ResultsA total of 21,765 patients with ILD were identified. Between 1995 and 1998 the overall standardised IR of ILD decreased from 27.14 (95% CI 25.82–28.46) per 100,000 person-years to 19.36 (95% CI 18.26–20.46) per 100,000 person-years. After 1998 the IR increased considerably, peaking at 34.34 (95% CI 32.84–35.85) per 100,000 person-years in 2002. Subsequently there was a slight decrease. The highest IR was observed in the non-specific category "Respiratory disorders in diseases classified elsewhere". By ILD subcategory, the greatest average increase during the study period was observed in "Respiratory disorders in diseases classified elsewhere".ConclusionThe incidence rate of ILD in Denmark increased during the study period, most pronounced for ILDs associated with systemic diseases.

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Section: Discussionmentioning

confidence: 99%

The incidence of interstitial lung disease 1995–2005: a Danish nationwide population-based study

et al. 2008

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“…Hormonal therapy in an adjuvant setting can be used sequentially as well as concurrently with RT. Among these substances, the widely used tamoxifen combined with chemoradiotherapy has been shown to act as a possible enhancer of radiation-induced pneumonitis [ 36 ], lung fibrosis [ 37 ], or occasionally even of lethal pneumonia [ 38 ].…”

Section: Introductionmentioning

confidence: 99%

Occurrence of pneumonitis following radiotherapy of breast cancer – A prospective study

et al. 2018

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Aimof this study is to determine the temporal resolution of therapy-induced pneumonitis, and to assess promoting factors in adjuvant treated patients with unilateral mammacarcinoma.Patients and methodsA total of 100 post-surgery patients were recruited. The cohort was treated by 2 field radiotherapy (2FRT; breast and chest wall, N = 75), 3 field radiotherapy (3FRT; + supraclavicular lymphatic region, N = 8), or with 4 field radiotherapy (4FRT; + parasternal lymphatic region, N = 17). Ninety-one patients received various systemic treatments prior to irradiation. Following an initial screening visit post-RT, two additional visits after 12 and 25 weeks were conducted including radiographic examination. In addition, general anamnesis and the co-medication were recorded. The endpoint was reached as soon as a pneumonitis was developed or at maximum of six months post-treatment.ResultsA pneumonitis incidence of 13% was determined. Of 91 patients with prior systemic therapy, 11 patients developed pneumonitis. Smoking history and chronic obstructive pulmonary disease (COPD) appeared to be positive predictors, whereas past pneumonia clearly promoted pneumonitis. Further pneumonitis-promoting predictors are represented by the applied field extensions (2 field radiotherapy [2FRT] < 3 field radiotherapy [3FRT] < 4 field radiotherapy [4FRT]) and the type of combined initial systemic therapies. As a consequence, all of the three patients in the study cohort treated with 4FRT and initial chemotherapy combined with anti-hormone and antibody protocols developed pneumonitis. A combination of the hormone antagonists tamoxifen and goserelin might enhance the risk for pneumonitis. Remarkably, none of the 11 patients co-medicated with statins suffered from pneumonitis.ConclusionsThe rapidly increasing use of novel systemic therapy schedules combined with radiotherapy (RT) needs more prospective studies with larger cohorts. Our results indicate that contribution to pneumonitis occurrence of various (neo)adjuvant therapy approaches followed by RT is of minor relevance, whereas mean total lung doses of >10 Gy escalate the risk of lung tissue complications. The validity of potential inhibitors of therapy-induced pneumonitis as observed for statin co-medication should further be investigated in future trials.

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“…Alternatively, research has been organized according to the adverse effects potentially related to radiation therapy [9], chemotherapy [10], or adjuvant endocrine therapies [11]. Rare, unusual, or late effects not routinely hypothesized to be associated with breast cancer or its therapies are often investigated only as case reports or case series [12-14]. …”

Section: Introductionmentioning

confidence: 99%

Comprehensive evaluation of the incidence of late effects in 5-year survivors of breast cancer

Lash

Thwin

Yood

et al. 2014

Breast Cancer Res Treat

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Purpose Late effects of breast cancer affect the quality of survivorship. Using administrative data, we compared the occurrence of almost all ICD9 codes among older breast cancer survivors to that among a matched comparison cohort to generate new hypotheses. Methods Breast cancer patients sixty-five years or older diagnosed 1990–1994 in six integrated care settings and who survived at least five years were matched with a cohort of women without a history of breast cancer on care setting, age, and calendar time. We collected data on the occurrence of incident ICD9 codes beginning six years after the breast cancer diagnosis date and continuing to year fifteen, and comparable data for the matched woman. We calculated hazard ratios and 95% confidence intervals associating breast cancer survivorship with incidence of each ICD9 code. We used semi-Bayes methods to address multiple comparisons. Results Older breast cancer survivors had about the same occurrence of diseases and conditions six to fifteen years after breast cancer diagnosis as comparable women. The median of 564 adjusted hazard ratios equaled 1.06, with interquartile range 0.92 to 1.3. The distribution of hazard ratios pertaining to cancer-related ICD codes was shifted towards positive associations, and the distribution pertaining to cardiovascular-related ICD codes was shifted towards negative associations. Conclusions In this hypothesis scanning study, we observed little difference in the occurrence of non-breast cancer-related diseases and conditions among older, long-term breast cancer survivors and comparable women without a history of breast cancer.

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Incidence of interstitial pneumonitis among breast cancer patients: a 10-year Danish population-based cohort study

Cited by 11 publications

References 20 publications

The incidence of interstitial lung disease 1995–2005: a Danish nationwide population-based study

The incidence of interstitial lung disease 1995–2005: a Danish nationwide population-based study

Occurrence of pneumonitis following radiotherapy of breast cancer – A prospective study

Comprehensive evaluation of the incidence of late effects in 5-year survivors of breast cancer

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