title: A patient with 17 primary tumours and a germ line mutation in TP53: tumour induction by adjuvant therapy?
abstract: We report the case history of a woman with a germ line mutation in the TP53 gene who developed 17 separate primary tumours. The incidence of new tumours rose steeply after adjuvant tamoxifen treatment for breast cancer and adjuvant vaginal vault radiotherapy for endometrial cancer. This increase could be due to cumulative genetic damage from environmental agents and the fact that the patient lived to the relatively late age of 60 years, or to a high inherent deleterious somatic mutation rate, which could represent the inability of cells from patients with TP53 mutations to repair therapy-induced genetic damage.
authors.affiliation: Royal Marsden NHS Trust, Sutton, UK.
authors.forename: C
authors.initials: C
authors.lastname: Nutting
authors.forename: R S
authors.initials: RS
authors.lastname: Camplejohn
authors.forename: R
authors.initials: R
authors.lastname: Gilchrist
authors.forename: D
authors.initials: D
authors.lastname: Tait
authors.forename: P
authors.initials: P
authors.lastname: Blake
authors.forename: G
authors.initials: G
authors.lastname: Knee
authors.forename: W Q
authors.initials: WQ
authors.lastname: Yao
authors.forename: G
authors.initials: G
authors.lastname: Ross
authors.forename: C
authors.initials: C
authors.lastname: Fisher
authors.forename: R
authors.initials: R
authors.lastname: Eeles
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy; D003131:Combined Modality Therapy; D005260:Female; D018095:Germ-Line Mutation; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy / Q000235:genetics* / Q000532:radiotherapy / Q000601:surgery; D010375:Pedigree; D016133:Polymerase Chain Reaction; D013629:Tamoxifen / Q000009:adverse effects*; D016159:Tumor Suppressor Protein p53 / Q000235:genetics*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D016159:Tumor Suppressor Protein p53; D013629:Tamoxifen