Breast cancer surveillance in patients treated by radiotherapy for Hodgkin’s lymphoma

• Published in: Radiologia medica 2013-04, Vol.118 (3), p.401-414
• Main Authors: Mariscotti, G., Durando, M., Ghione, G., Luparia, A., Regini, E., Alfieri, C., Campanino, P. P., Gavarotti, P., Brignardello, E., Gandini, G.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Breast Radiology; Diagnostic Radiology; Female; Hodgkin Disease - drug therapy; Hodgkin Disease - radiotherapy; Humans; Imaging; Interventional Radiology; Magnetic Resonance Imaging; Medicine; Medicine & Public Health; Middle Aged; Neoplasms, Radiation-Induced - pathology; Neoplasms, Radiation-Induced - therapy; Neuroradiology; Radiation Dosage; Radiology; Retrospective Studies; Risk Assessment; Risk Factors; Senologia; Ultrasound
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-012-0862-2

Purpose The authors evaluated the relative risk of developing radiation-induced breast cancer (BC) in women treated with radiotherapy for Hodgkin’s disease (HD) and analysed the imaging features of these breast neoplasms. Materials and methods We retrospectively studied 54 women who had all undergone radiotherapy between 1980 and 2010 (median age, 36.6 years). Women aged ≤30 years were screened with clinical breast examination, ultrasound (US) and, if necessary, mammography; women >30 years had clinical breast examination, US and mammography. Three women underwent magnetic resonance (MR) imaging as well. Results Mammography detected seven invasive breast cancers in 6/54 women (11.1%). Median age at diagnosis was 26.1 years for HD and 42.4 for breast cancer. Breast cancer was diagnosed following a median latent period from radiotherapy of 15.1 years. Mean radiation dose was 37.6 Gy in women who developed breast cancer and 31.3 Gy in the other women. Conclusions In our study, women who were exposed to radiation for HD had a 6.2-fold higher risk of developing breast cancer than the general population. In consideration of the young age and high breast density, women aged ≤30 years should be monitored by US and MR imaging; women aged >30 years should be monitored by US, mammography and, when necessary, MR imaging.