The group was diagnosed between 1973 and 1993 and in the 21 years of the study its members developed 116 primary esophageal cancers. In the subset of patients followed for at least 10 years after diagnosis, those who received radiation were four to five times more likely to develop esophageal cancer after a decade than nonirradiated patients or women in the general population. And the risk of squamous cell carcinoma rose to 7.59 when the analysis was restricted to women whose breast cancer was located in the inner half of the breast. Dr. Ahsan and his colleagues hasten to point out their findings in no way suggest patients should avoid lumpectomy followed by radiation, the standard therapy for early-stage breast cancer.
Common symptoms are difficulty and pain in swallowing.
The full report appears in the Jan. 15 Annals of Internal Medicine. In earlier work, the Columbia researchers showed breast irradiation raised lung cancer risk, especially in smoking irradiated patients, who had 40 times the risk of lung cancer. With esophageal cancer, the combined effect of irradiation and smoking may be even more dramatic. In addition to smoking, the study will also analyse the effects of radiation dose, alcohol consumption and body mass index on esophageal cancer in breast cancer patients. The general incidence of esophageal adenocarcinomas is rising and researchers think anthropometric factors such as obesity may be implicated.