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. 2021 Aug 3;23(1):79.
doi: 10.1186/s13058-021-01456-1.

Diagnostic chest X-rays and breast cancer risk among women with a hereditary predisposition to breast cancer unexplained by a BRCA1 or BRCA2 mutation

Maximiliano Ribeiro Guerra  1   2   3   4   5 , Juliette Coignard  1   2   3   4 , Séverine Eon-Marchais  1   2   3   4 , Marie-Gabrielle Dondon  1   2   3   4 , Dorothée Le Gal  1   2   3   4 , Juana Beauvallet  1   2   3   4 , Noura Mebirouk  1   2   3   4 , Muriel Belotti  6 , Olivier Caron  7 , Marion Gauthier-Villars  6 , Isabelle Coupier  8   9 , Bruno Buecher  6 , Alain Lortholary  10 , Jean-Pierre Fricker  11 , Paul Gesta  12 , Catherine Noguès  13   14 , Laurence Faivre  15   16 , Pascaline Berthet  17 , Elisabeth Luporsi  18 , Capucine Delnatte  19 , Valérie Bonadona  20   21   22 , Christine M Maugard  23   24 , Pascal Pujol  8   9 , Christine Lasset  20   21   22 , Michel Longy  25 , Yves-Jean Bignon  26 , Claude Adenis-Lavignasse  27 , Laurence Venat-Bouvet  28 , Hélène Dreyfus  29   30 , Laurence Gladieff  31 , Isabelle Mortemousque  32 , Séverine Audebert-Bellanger  33 , Florent Soubrier  34 , Sophie Giraud  35 , Sophie Lejeune-Dumoulin  36 , Jean-Marc Limacher  37 , Jean Chiesa  38 , Anne Fajac  39 , Anne Floquet  25 , François Eisinger  13   14 , Julie Tinat  40 , Sandra Fert-Ferrer  41 , Chrystelle Colas  6   42 , Thierry Frebourg  43 , Francesca Damiola  44 , Laure Barjhoux  45 , Eve Cavaciuti  1   2   3   4 , Sylvie Mazoyer  46 , Anne Tardivon  47 , Fabienne Lesueur  1   2   3   4 , Dominique Stoppa-Lyonnet  6   48   49 , Nadine Andrieu  50   51   52   53
Affiliations

Diagnostic chest X-rays and breast cancer risk among women with a hereditary predisposition to breast cancer unexplained by a BRCA1 or BRCA2 mutation

Maximiliano Ribeiro Guerra et al. Breast Cancer Res. .

Abstract

Background: Diagnostic ionizing radiation is a risk factor for breast cancer (BC). BC risk increases with increased dose to the chest and decreases with increased age at exposure, with possible effect modification related to familial or genetic predisposition. While chest X-rays increase the BC risk of BRCA1/2 mutation carriers compared to non-carriers, little is known for women with a hereditary predisposition to BC but who tested negative for a BRCA1 or BRCA2 (BRCA1/2) mutation.

Methods: We evaluated the effect of chest X-rays from diagnostic medical procedures in a dataset composed of 1552 BC cases identified through French family cancer clinics and 1363 unrelated controls. Participants reported their history of X-ray exposures in a detailed questionnaire and were tested for 113 DNA repair genes. Logistic regression and multinomial logistic regression models were used to assess the association with BC.

Results: Chest X-ray exposure doubled BC risk. A 3% increased BC risk per additional exposure was observed. Being 20 years old or younger at first exposure or being exposed before first full-term pregnancy did not seem to modify this risk. Birth after 1960 or carrying a rare likely deleterious coding variant in a DNA repair gene other than BRCA1/2 modified the effect of chest X-ray exposure.

Conclusion: Ever/never chest X-ray exposure increases BC risk 2-fold regardless of age at first exposure and, by up to 5-fold when carrying 3 or more rare variants in a DNA repair gene. Further studies are needed to evaluate other DNA repair genes or variants to identify those which could modify radiation sensitivity. Identification of subpopulations that are more or less susceptible to ionizing radiation is important and potentially clinically relevant.

Keywords: Breast cancer; DNA repair genes; High-risk population; Low dose; X-ray exposure.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Recruitment process for index cases and unrelated controls
See this image and copyright information in PMC

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