Breast cancer risk following radiotherapy for Hodgkin lymphoma: modification by other risk factors

• Published in: Blood Vol. 106; no. 10; pp. 3358 - 3365
• Main Authors: Hill, Deirdre A., Gilbert, Ethel, Dores, Graça M., Gospodarowicz, Mary, van Leeuwen, Flora E., Holowaty, Eric, Glimelius, Bengt, Andersson, Michael, Wiklund, Tom, Lynch, Charles F., van't Veer, Mars, Storm, Hans, Pukkala, Eero, Stovall, Marilyn, Curtis, Rochelle E., Allan, James M., Boice, John D., Travis, Lois B.
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 15-11-2005; The Americain Society of Hematology; The American Society of Hematology
• Subjects: Adult; Biological and medical sciences; Breast Neoplasms - etiology; Breast Neoplasms - mortality; Clinical Trials and Observations; Female; Gynecology. Andrology. Obstetrics; Hematologic and hematopoietic diseases; Hodgkin Disease - complications; Hodgkin Disease - mortality; Hodgkin Disease - radiotherapy; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Mammary gland diseases; Medical sciences; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Middle Aged; Neoplasms, Radiation-Induced - etiology; Neoplasms, Radiation-Induced - mortality; Neoplasms, Second Primary - etiology; Neoplasms, Second Primary - mortality; Odds Ratio; Radiotherapy Dosage; Retrospective Studies; Risk Factors; Tumors; Human; Mammary gland diseases; Treatment; Lymphoproliferative syndrome; Risk factor; Complication; Hodgkin disease; Malignant hemopathy; Breast cancer; Malignant tumor; Radiotherapy; Lymphoma
• ISSN: 0006-4971; 1528-0020; 1528-0020
• DOI: 10.1182/blood-2005-04-1535

The importance of genetic and other risk factors in the development of breast cancer after radiotherapy (RT) for Hodgkin lymphoma (HL) has not been determined. We analyzed data from a breast cancer case-control study (105 patients, 266 control subjects) conducted among 3 817 survivors of HL diagnosed at age 30 years or younger in 6 population-based cancer registries. Odds ratios (ORs) and excess relative risks (ERRs) were calculated using conditional regression. Women who received RT exposure (≥ 5 Gy radiation dose to the breast) had a 2.7-fold increased breast cancer risk (95% confidence interval (CI) 1.4-5.2), compared with those given less than 5 Gy. RT exposure (≥ 5 Gy) was associated with an OR of 0.8 (95% CI, 0.2-3.4) among women with a first- or second-degree family history of breast or ovarian cancer, and 5.8 (95% CI, 2.1-16.3) among all other women (interaction P = .03). History of a live birth appeared to increase the breast cancer risk associated with RT among women not treated with ovarian-damaging therapies. Breast cancer risk following RT varied little according to other factors. The additional increased relative risk of breast cancer after RT for HL is unlikely to be larger among women with a family history of breast or ovarian cancer than among other women.