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Risk, characteristics, and prognosis of breast cancer after Hodgkin's lymphoma.

Abstract

PURPOSE

To assess breast cancer (BC) risk after Hodgkin's lymphoma (HL) and compare characteristics, risk of second BC, and prognosis of patients with these BCs with patients with first primary BC.

PATIENTS AND METHODS

We considered all 9,620 women with HL recorded in the Surveillance, Epidemiology and End Results dataset in 1973-2007. We calculated age-period standardized incidence ratios of BC. We compared patient, tumor, and treatment characteristics, risk of second BC, and prognosis between patients with BC after HL (n = 316) and patients with other BCs occurring during the same period (n = 450,413) using logistic regression and Cox models adjusted for confounders.

RESULTS

HL patients had a 2.4-fold higher risk for developing BC (95% confidence interval [CI], 2.2-2.7) than the general population. Age at HL diagnosis and radiation therapy influenced this risk. Compared with first primary BCs, BCs after HL were diagnosed at a younger age, at an earlier stage, were less frequently hormone receptor positive, were located more frequently in external quadrants, and were less frequently treated using radiotherapy. These patients had a higher risk (adjusted hazard ratio [HR], 2.85; 95% CI, 1.79-4.53) for developing a second BC and had a higher BC mortality risk (adjusted HR, 1.36; 95% CI, 1.05-1.76). The higher mortality risk was only partly explained by the higher occurrence rate of a second BC.

CONCLUSION

HL survivors have a higher risk for developing BC, their BCs are more aggressive, they have a higher risk for a second BC occurrence, and they have a poorer prognosis. Guidelines of care should be adapted to decrease the impact of BC in these high-risk patients.

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    Geneva Cancer Registry, 55 Boulevard de la Cluse, Geneva, Switzerland.

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    Source

    The oncologist 17:6 2012 pg 783-91

    MeSH

    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Breast Neoplasms
    Child
    Child, Preschool
    Cohort Studies
    Female
    Follow-Up Studies
    Hodgkin Disease
    Humans
    Incidence
    Middle Aged
    Neoplasms, Second Primary
    Prognosis
    Proportional Hazards Models
    Risk Assessment
    Risk Factors
    Survival Rate
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22588325

    Citation

    Veit-Rubin, Nikolaus, et al. "Risk, Characteristics, and Prognosis of Breast Cancer After Hodgkin's Lymphoma." The Oncologist, vol. 17, no. 6, 2012, pp. 783-91.
    Veit-Rubin N, Rapiti E, Usel M, et al. Risk, characteristics, and prognosis of breast cancer after Hodgkin's lymphoma. Oncologist. 2012;17(6):783-91.
    Veit-Rubin, N., Rapiti, E., Usel, M., Benhamou, S., Vinh-Hung, V., Vlastos, G., & Bouchardy, C. (2012). Risk, characteristics, and prognosis of breast cancer after Hodgkin's lymphoma. The Oncologist, 17(6), pp. 783-91. doi:10.1634/theoncologist.2011-0451.
    Veit-Rubin N, et al. Risk, Characteristics, and Prognosis of Breast Cancer After Hodgkin's Lymphoma. Oncologist. 2012;17(6):783-91. PubMed PMID: 22588325.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Risk, characteristics, and prognosis of breast cancer after Hodgkin's lymphoma. AU - Veit-Rubin,Nikolaus, AU - Rapiti,Elisabetta, AU - Usel,Massimo, AU - Benhamou,Simone, AU - Vinh-Hung,Vincent, AU - Vlastos,Georges, AU - Bouchardy,Christine, Y1 - 2012/05/15/ PY - 2012/5/17/entrez PY - 2012/5/17/pubmed PY - 2012/11/13/medline SP - 783 EP - 91 JF - The oncologist JO - Oncologist VL - 17 IS - 6 N2 - PURPOSE: To assess breast cancer (BC) risk after Hodgkin's lymphoma (HL) and compare characteristics, risk of second BC, and prognosis of patients with these BCs with patients with first primary BC. PATIENTS AND METHODS: We considered all 9,620 women with HL recorded in the Surveillance, Epidemiology and End Results dataset in 1973-2007. We calculated age-period standardized incidence ratios of BC. We compared patient, tumor, and treatment characteristics, risk of second BC, and prognosis between patients with BC after HL (n = 316) and patients with other BCs occurring during the same period (n = 450,413) using logistic regression and Cox models adjusted for confounders. RESULTS: HL patients had a 2.4-fold higher risk for developing BC (95% confidence interval [CI], 2.2-2.7) than the general population. Age at HL diagnosis and radiation therapy influenced this risk. Compared with first primary BCs, BCs after HL were diagnosed at a younger age, at an earlier stage, were less frequently hormone receptor positive, were located more frequently in external quadrants, and were less frequently treated using radiotherapy. These patients had a higher risk (adjusted hazard ratio [HR], 2.85; 95% CI, 1.79-4.53) for developing a second BC and had a higher BC mortality risk (adjusted HR, 1.36; 95% CI, 1.05-1.76). The higher mortality risk was only partly explained by the higher occurrence rate of a second BC. CONCLUSION: HL survivors have a higher risk for developing BC, their BCs are more aggressive, they have a higher risk for a second BC occurrence, and they have a poorer prognosis. Guidelines of care should be adapted to decrease the impact of BC in these high-risk patients. SN - 1549-490X UR - https://www.unboundmedicine.com/medline/citation/22588325/Risk_characteristics_and_prognosis_of_breast_cancer_after_Hodgkin's_lymphoma_ L2 - http://theoncologist.alphamedpress.org/cgi/pmidlookup?view=long&pmid=22588325 DB - PRIME DP - Unbound Medicine ER -