Novi primarni zloćudni tumori nakon dijagnoze raka dojke: međuodnos naslijeđa, rizičnih čimbenika i modaliteta liječenja [New primary malignancies after breast cancer diagnosis: interplay of genetics, risk factors and treatment modalities].

Dedić Plavetić, Natalija and Barić, Marina and Solarić, Mladen and Vrbanec, Damir (2013) Novi primarni zloćudni tumori nakon dijagnoze raka dojke: međuodnos naslijeđa, rizičnih čimbenika i modaliteta liječenja [New primary malignancies after breast cancer diagnosis: interplay of genetics, risk factors and treatment modalities]. Liječnički vjesnik, 135 (1-2). pp. 27-33. ISSN 0024-3477

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Abstract

Significant advances in early breast cancer detection and increased quality of care within developed countries resulted in longer than five years survival in almost 90% of women diagnosed and treated for breast cancer. One in twenty women diagnosed with breast cancer will develop a new primary non-breast malignancy within 10 years from initial diagnosis. Mutations in BRCA 1 i 2, RAD51C, MMR, p53, CDKN2A and 113insArg genes are linked with increased risk of breast cancer and other cancer sites. It seems that treatment modalities also play significant role in development of new primary malignancies. Tissues that receive higher doses of radiation during radiotherapy of breast cancer are under increased risk of developing new primary tumor, especially in younger women, ten years after the treatment. Chemotherapy may cause higher incidence of leukemia and myelodysplastic syndrome but lower overall risk for development of other malignancies. Connection between tamoxifen therapy and increased risk of endometrial cancer is well known and confirmed also in recent studies. The true mechanism of cancer development is still unclear. Significance of hereditary factors, possible common environmental risk factors or unwanted side effects of the specific anticancer treatments are yet to be discovered.

Abstract in Croatian

Značajan napredak u ranom otkrivanju i kvalitetnije liječenje oboljelih rezultirali su činjenicom da u najrazvijenijim zemljama gotovo 90% žena s dijagnozom raka dojke preživi duže od 5 godina nakon dijagnoze i liječenja. Kod jedne od dvadeset žena oboljelih od raka dojke unutar 10 godina od postavljanja dijagnoze razvit će se novi primarni tumor čije sijelo nije dojka. Mutacije gena BRCA 1 i 2, RAD51C, MMR, p53, CDKN2A te 113insArg povezuju se s povećanim rizikom od razvoja raka dojke i drugih zloćudnih tumora. Čini se da i modalitet liječenja utječe na povećanje rizika od razvoja novoga zloćudnog tumora. Tako je nakon radioterapije primijećen povećan rizik za tkiva koja primaju višu dozu zračenja, osobito kod mlađih bolesnica, desetak godina nakon zračenja. Nađena je povećana incidencija leukemije i mijelodisplastičnog sindroma nakon liječenja kemoterapijom u odnosu na opću populaciju, ali smanjen rizik od razvoja zloćudnih tumora ostalih sijela. Odranije poznat povećan rizik od razvoja raka endometrija nakon hormonske terapije tamoksifenom potvrđen je i u novijim studijama. Mehanizam nastanka novih primarnih zloćudnih tumora nije potpuno razjašnjen. Koliki udio u tome imaju zajednički nasljedni čimbenici, mogući zajednički okolišni rizični čimbenici ili neželjene nuspojave specifičnog onkološkog liječenja tek se treba otkriti.

Item Type: Article
MeSH: Breast Neoplasms/diagnosis ; Breast Neoplasms/genetics ; Breast Neoplasms/therapy ; Female ; Humans ; Neoplasms, Second Primary/diagnosis ; Neoplasms, Second Primary/etiology
Departments: Katedra za radiologiju i opću kliničku onkologiju
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Dedić Plavetić, NatalijaUNSPECIFIED
Barić, MarinaUNSPECIFIED
Solarić, MladenUNSPECIFIED
Vrbanec, DamirUNSPECIFIED
Date: January 2013
Date Deposited: 13 Oct 2015 13:25
Last Modified: 30 Sep 2019 12:26
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2281

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