Characteristics and outcomes of breast cancer in women with and without a history of radiation for Hodgkin's lymphoma: A multi-institutional, matched cohort study Journal Article


Authors: Elkin, E. B.; Klem, M. L.; Gonzales, A. M.; Ishill, N. M.; Hodgson, D.; Ng, A. K.; Marks, L. B.; Weidhaas, J.; Freedman, G. M.; Miller, R. C.; Constine, L. S.; Myrehaug, S.; Yahalom, J.
Article Title: Characteristics and outcomes of breast cancer in women with and without a history of radiation for Hodgkin's lymphoma: A multi-institutional, matched cohort study
Abstract: Purpose: To compare characteristics and outcomes of breast cancer in women with and without a history of radiation therapy (RT) for Hodgkin's lymphoma (HL). Patients and Methods: Women with breast cancer diagnosed from 1980 to 2006 after RT for HL were identified from eight North American hospitals and were matched three-to-one with patients with sporadic breast cancer by age, race, and year of breast cancer diagnosis. Information on patient, tumor and treatment characteristics, and clinical outcomes was abstracted from medical records. Results: A total of 253 patients with breast cancer with a history of RT for HL were matched with 741 patients with sporadic breast cancer. Median time from HL to breast cancer diagnosis was 18 years. Median age at breast cancer diagnosis was 42 years. Breast cancer after RT for HL was more likely to be detected by screening, was more likely to be diagnosed at an earlier stage, and was more likely to be bilateral at diagnosis. HL survivors had an increased risk of metachronous contralateral breast cancer (adjusted hazard ratio [HR], 4.3; 95% CI, 1.7 to 11.0) and death as a result of any cause (adjusted HR, 1.9; 95% CI, 1.1 to 3.3). Breast cancer-specific mortality was also elevated, but this difference was not statistically significant (adjusted HR, 1.6; 95% CI, 0.7 to 3.4). Conclusion: In women with a history of RT for HL, breast cancer is diagnosed at an earlier stage, but these women are at greater risk for bilateral disease and are more likely to die as a result of causes other than breast cancer. Our findings support close follow-up for contralateral tumors in these patients and ongoing primary care to manage comorbid conditions. © 2011 by American Society of Clinical Oncology.
Keywords: adult; cancer chemotherapy; cancer survival; aged; major clinical study; overall survival; anamnesis; cancer radiotherapy; disease free survival; cancer staging; antineoplastic agent; cancer diagnosis; breast cancer; mastectomy; epidermal growth factor receptor 2; cohort analysis; hodgkin disease; cancer survivor; cancer hormone therapy; mammography; partial mastectomy; intraductal carcinoma; race
Journal Title: Journal of Clinical Oncology
Volume: 29
Issue: 18
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2011-06-20
Start Page: 2466
End Page: 2473
Language: English
DOI: 10.1200/jco.2010.32.4079
PROVIDER: scopus
PMCID: PMC3138631
PUBMED: 21576642
DOI/URL:
Notes: --- - "Export Date: 17 August 2011" - "CODEN: JCOND" - "Source: Scopus"
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MSK Authors
  1. Joachim Yahalom
    407 Yahalom
  2. Elena B Elkin
    151 Elkin
  3. Nicole Marie Leoce
    86 Leoce