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Long-term survival among patients with Hodgkin's lymphoma who developed breast cancer: a population-based study.
J Clin Oncol 2010; 28(34):5088-96JC

Abstract

PURPOSE

The increased risk of breast cancer (BC) among women receiving chest radiotherapy for Hodgkin's lymphoma (HL) is well-established. However, there are no large population-based studies that describe overall survival (OS) and cause-specific survival (CSS) compared with women with first primary BC.

METHODS

For 298 HL survivors who developed BC (HL-BC group) and 405,223 women with a first or only BC (BC-1 group), actuarial OS and CSS were compared, accounting for age, BC stage, hormone receptor status, sociodemographic status, radiation for HL, and other variables. All patients were derived from the population-based Surveillance, Epidemiology, and End Results program.

RESULTS

OS among patients with HL-BC was significantly inferior that of to patients with BC-1: 15-year OS was 48% versus 69% (P < .0001) for localized BC, and 33% versus 43% (P < .0001) for regional/distant BC. Patients with HL-BC had a significantly increased seven-fold risk (P < .0001) of death from other cancers (ie, not HL or BC) compared with patients with BC-1. Mortality from heart disease among patients with HL-BC with either localized or regional/distant disease was also significantly increased (hazard ratio = 2.22, P = .04; and hazard ratio = 4.28, P = .02, respectively) compared with patients with BC-1. Although 10-year BC-CSS was similar for patients with HL-BC and BC-1 with regional/distant disease, it was inferior for patients with localized BC (82% v 88%, respectively; P = .002).

CONCLUSION

Women with HL may survive a subsequent diagnosis of BC, only to experience significant excesses of death from other primary cancers and cardiac disease. Greater awareness of screening for cardiac disease and subsequent primary cancers in patients with HL-BC is warranted.

Authors+Show Affiliations

Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY 14642, USA. michael_milano@urmc.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20975072

Citation

Milano, Michael T., et al. "Long-term Survival Among Patients With Hodgkin's Lymphoma Who Developed Breast Cancer: a Population-based Study." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 28, no. 34, 2010, pp. 5088-96.
Milano MT, Li H, Gail MH, et al. Long-term survival among patients with Hodgkin's lymphoma who developed breast cancer: a population-based study. J Clin Oncol. 2010;28(34):5088-96.
Milano, M. T., Li, H., Gail, M. H., Constine, L. S., & Travis, L. B. (2010). Long-term survival among patients with Hodgkin's lymphoma who developed breast cancer: a population-based study. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 28(34), pp. 5088-96. doi:10.1200/JCO.2010.29.5683.
Milano MT, et al. Long-term Survival Among Patients With Hodgkin's Lymphoma Who Developed Breast Cancer: a Population-based Study. J Clin Oncol. 2010 Dec 1;28(34):5088-96. PubMed PMID: 20975072.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term survival among patients with Hodgkin's lymphoma who developed breast cancer: a population-based study. AU - Milano,Michael T, AU - Li,Huilin, AU - Gail,Mitchell H, AU - Constine,Louis S, AU - Travis,Lois B, Y1 - 2010/10/25/ PY - 2010/10/27/entrez PY - 2010/10/27/pubmed PY - 2011/1/5/medline SP - 5088 EP - 96 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 28 IS - 34 N2 - PURPOSE: The increased risk of breast cancer (BC) among women receiving chest radiotherapy for Hodgkin's lymphoma (HL) is well-established. However, there are no large population-based studies that describe overall survival (OS) and cause-specific survival (CSS) compared with women with first primary BC. METHODS: For 298 HL survivors who developed BC (HL-BC group) and 405,223 women with a first or only BC (BC-1 group), actuarial OS and CSS were compared, accounting for age, BC stage, hormone receptor status, sociodemographic status, radiation for HL, and other variables. All patients were derived from the population-based Surveillance, Epidemiology, and End Results program. RESULTS: OS among patients with HL-BC was significantly inferior that of to patients with BC-1: 15-year OS was 48% versus 69% (P < .0001) for localized BC, and 33% versus 43% (P < .0001) for regional/distant BC. Patients with HL-BC had a significantly increased seven-fold risk (P < .0001) of death from other cancers (ie, not HL or BC) compared with patients with BC-1. Mortality from heart disease among patients with HL-BC with either localized or regional/distant disease was also significantly increased (hazard ratio = 2.22, P = .04; and hazard ratio = 4.28, P = .02, respectively) compared with patients with BC-1. Although 10-year BC-CSS was similar for patients with HL-BC and BC-1 with regional/distant disease, it was inferior for patients with localized BC (82% v 88%, respectively; P = .002). CONCLUSION: Women with HL may survive a subsequent diagnosis of BC, only to experience significant excesses of death from other primary cancers and cardiac disease. Greater awareness of screening for cardiac disease and subsequent primary cancers in patients with HL-BC is warranted. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/20975072/Long_term_survival_among_patients_with_Hodgkin's_lymphoma_who_developed_breast_cancer:_a_population_based_study_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2010.29.5683?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -