Cumulative absolute breast cancer risk for young women treated for Hodgkin lymphoma

Lois B Travis; Deirdre Hill; Graça M Dores; Mary Gospodarowicz; Flora E van Leeuwen; Eric Holowaty; Bengt Glimelius; Michael Andersson; Eero Pukkala; Charles F Lynch; David Pee; Susan A Smith; Mars B Van't Veer; Timo Joensuu; Hans Storm; Marilyn Stovall; John D Boice Jr; Ethel Gilbert; Mitchell H Gail

doi:10.1093/jnci/dji290

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Cumulative absolute breast cancer risk for young women treated for Hodgkin lymphoma

Journal article

Open access

Peer reviewed

Cumulative absolute breast cancer risk for young women treated for Hodgkin lymphoma

Lois B Travis, Deirdre Hill, Graça M Dores, Mary Gospodarowicz, Flora E van Leeuwen, Eric Holowaty, Bengt Glimelius, Michael Andersson, Eero Pukkala, Charles F Lynch, …

JNCI : Journal of the National Cancer Institute, Vol.97(19), pp.1428-1437

10/05/2005

DOI: 10.1093/jnci/dji290

PMID: 16204692

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Abstract

Many women develop breast cancer after treatment for Hodgkin lymphoma (HL) at a young age. We estimated this future risk, taking into account age and calendar year of HL diagnosis, HL treatment information, population breast cancer incidence rates, and competing causes of death. Relative risks of breast cancer for categories defined by radiation dose to the chest (0, 20- < 40 Gy, or > or = 40 Gy) and use of alkylating agents (yes or no) were estimated from a case-control study conducted within an international population-based cohort of 3817 female 1-year survivors of HL diagnosed at age 30 years or younger from January 1, 1965, through December 31, 1994. To compute cumulative absolute risks of breast cancer, we used modified standardized incidence ratios to relate cohort breast cancer risks to those in the general population, enabling application of population-based breast cancer rates, and we allowed for competing risks by using population-based mortality rates in female HL survivors. Cumulative absolute risks of breast cancer increased with age at end of follow-up, time since HL diagnosis, and radiation dose. For an HL survivor who was treated at age 25 years with a chest radiation dose of at least 40 Gy without alkylating agents, estimated cumulative absolute risks of breast cancer by age 35, 45, and 55 years were 1.4% (95% confidence interval [CI] = 0.9% to 2.1%), 11.1% (95% CI = 7.4% to 16.3%), and 29.0% (95% CI = 20.2% to 40.1%), respectively. Cumulative absolute risks were lower in women treated with alkylating agents. Breast cancer projections varied considerably by type of HL therapy, time since HL diagnosis, and age at end of follow-up. These estimates are applicable to HL survivors treated with regimens of the past and can be used to counsel such patients and plan management and preventive strategies. Projections should be used with caution, however, in patients treated with more recent approaches, including limited-field radiotherapy and/or ovary-sparing chemotherapy.

Humans

Middle Aged

Neoplasms, Radiation-Induced - etiology

Netherlands - epidemiology

Breast Neoplasms - etiology

Antineoplastic Agents, Alkylating - administration & dosage

Case-Control Studies

Incidence

Hodgkin Disease - radiotherapy

Chemotherapy, Adjuvant - adverse effects

Radiotherapy, Adjuvant - adverse effects

Hodgkin Disease - drug therapy

Adult

Female

Iowa - epidemiology

Odds Ratio

Breast Neoplasms - epidemiology

Radiotherapy Dosage

SEER Program

Risk Assessment

Risk Factors

Sweden - epidemiology

Neoplasms, Second Primary - epidemiology

Neoplasms, Second Primary - etiology

Ontario - epidemiology

Denmark - epidemiology

Antineoplastic Agents, Alkylating - adverse effects

Neoplasms, Radiation-Induced - epidemiology

Finland - epidemiology

Cohort Studies

Details

Title: Subtitle: Cumulative absolute breast cancer risk for young women treated for Hodgkin lymphoma
Creators: Lois B Travis - Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA. travisl@mail.nih.gov
Deirdre Hill
Graça M Dores
Mary Gospodarowicz
Flora E van Leeuwen
Eric Holowaty
Bengt Glimelius
Michael Andersson
Eero Pukkala
Charles F Lynch
David Pee
Susan A Smith
Mars B Van't Veer
Timo Joensuu
Hans Storm
Marilyn Stovall
John D Boice Jr
Ethel Gilbert
Mitchell H Gail
Resource Type: Journal article
Publication Details: JNCI : Journal of the National Cancer Institute, Vol.97(19), pp.1428-1437
DOI: 10.1093/jnci/dji290
PMID: 16204692
NLM abbreviation: J Natl Cancer Inst
ISSN: 1460-2105
eISSN: 1460-2105
Publisher: Oxford University Press; United States
Grant note: Intramural NIH HHS
Language: English
Date published: 10/05/2005
Academic Unit: Epidemiology
Record Identifier: 9983996096302771

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