{"id":24427,"date":"2026-08-19T15:31:19","date_gmt":"2026-08-19T19:31:19","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=24427"},"modified":"2026-08-25T15:35:30","modified_gmt":"2026-08-25T19:35:30","slug":"breast-cancer-risk-among-survivors-of-hematopoietic-stem-cell-transplant-with-or-without-total-body-irradiation","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/breast-cancer-risk-among-survivors-of-hematopoietic-stem-cell-transplant-with-or-without-total-body-irradiation\/","title":{"rendered":"Breast cancer risk among survivors of hematopoietic stem cell transplant with or without total body irradiation: a population-based analysis"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Prior therapeutic chest radiation is a known risk factor for breast cancer (BC) development. Whether female patients who have been exposed to lower doses during total body irradiation (TBI) as part of a conditioning regimen for hematopoietic stem cell transplant (HSCT) also experience an increased risk is less clear.<\/p>\n<p><strong>Objectives<\/strong> \u2014 To compare the age-adjusted risk of BC in female patients who were or were not exposed to TBI in the context of a HSCT and to further compare the risk of BC in these patients to that of the general population.<\/p>\n<p><strong>Study design<\/strong> \u2014 We identified a cohort of female patients who underwent HSCT with or without TBI prior to or at age 65 for a primary diagnosis of leukemia or myelodysplastic syndrome (MDS) in Ontario, Canada between April 1, 1988, and December 31, 2019, and who had survived for at least five years after their transplant date (n\u202f=\u202f862). Fine and Gray methods were used to perform competing risks regressions analyzing the impact of TBI on BC risk, with death as a competing event, amongst the HSCT recipients, and also between the HSCT recipients and 100 general population matched controls per HSCT patient.<\/p>\n<p><strong>Results<\/strong> \u2014 An increased risk of BC was observed in the 535 HSCT recipients treated with TBI as compared to the 327 HSCT recipients who did not receive TBI on univariate analysis as well as a multivariable analysis adjusted for age (HR 3.16, 95% CI 1.33 \u2013 7.48). The increased risk of BC after TBI was observed in subgroups of interest including patients who were less than or older than 30 years of age at the time of HSCT. HSCT recipients treated with TBI also had an increased risk of BC as compared to matched general population controls (HR 2.35, 95% CI 1.62 \u2013 3.40). No increased risk of BC was observed amongst HSCT recipients who did not receive TBI compared to matched controls (HR 0.93, 95% CI 0.45 \u2013 1.94). Median latency to BC diagnosis was 17.3 years (range 5.4 to 31.0 years) post-transplant in the affected HSCT recipients. The median age at BC diagnosis was 57 in the affected HSCT recipients and was 61 in the control groups. TBI-exposed survivors had a 3.4% (95% CI 1.2 \u2013 9.6%), 10.8% (95% CI 6.7 \u2013 17.2%), and 25.1% (95% CI 15.8 \u2013 39.9%) cumulative incidence of BC development by attained age 40, 60, and 80, respectively, after accounting for their competing risk of death.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Female patients exposed to TBI in the context of HSCT for a primary diagnosis of leukemia or MDS have a higher risk of BC development as compared to those who underwent HSCT without TBI and matched general population controls. Recommendations for intensified BC screening are warranted for these patients.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Prior therapeutic chest radiation is a known risk factor for breast cancer (BC) development. Whether female patients who have been exposed to lower doses during total body irradiation (TBI) as part of a conditioning regimen for hematopoietic stem cell transplant (HSCT) also experience an increased risk is less clear. Objectives \u2014 To compare [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[38],"migration-helper-qa-sample-set":[],"class_list":["post-24427","journal_article","type-journal_article","status-publish","hentry","topic-cancer-and-cancer-screening"],"acf":{"citation":"van Rensburg HJJ, He J, Liu N, Hodgson D, Seely JM, Paszat L, Warner E, Lipton JH. <em>Transplant Cell Ther<\/em>. 2026; S2666-6367(26)00672-X. Epub 2026 Aug 19.","source_url":"https:\/\/doi.org\/10.1016\/j.jtct.2026.08.030","ices_scientist":[1261,1099],"site":[6733],"research_program":[6741],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Breast cancer risk among survivors of hematopoietic stem cell transplant with or without total body irradiation: a population-based analysis<\/title>\n<meta name=\"description\" content=\"Background \u2014 Prior therapeutic chest radiation is a known risk factor for breast cancer (BC) development. 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