Original ArticleRisk of Breast Cancer and Breast Cancer Characteristics in Women Treated With Supradiaphragmatic Radiation for Hodgkin Lymphoma: Mayo Clinic Experience
Section snippets
Population
Between 1950 and 1993, 653 women with an initial diagnosis of Hodgkin lymphoma received radiation therapy to nodal areas above the diaphragm as their initial treatment at the Mayo Clinic in Rochester, Minn. Four of these women had a diagnosis of breast cancer before they received their diagnosis of Hodgkin lymphoma. The remaining 649 women were included in the study.
Patient Data
The complete Mayo Clinic medical records of all women in our study until 2000 were abstracted to obtain demographic and clinical
Risk of Breast Cancer After Treatment of Hodgkin Lymphoma
The 649 female patients were followed through their Mayo Clinic medical records from the initiation of radiation therapy until the last date recorded, for a total of 7216 person-years (median, 8.6 years; range, <1–47.4 years), during which time 27 cases of breast cancer were observed. With only 9.1 cases expected, this corresponds to an estimated SMR of 3.0 (95% CI, 1.9–4.3). The Mayo Clinic records indicated that 295 of these women were deceased. The remaining 354 patients, presumably alive,
DISCUSSION
The risk of breast cancer developing after supradiaphragmatic radiation therapy for Hodgkin lymphoma among 649 patients who were treated at the Mayo Clinic between 1950 and 1993 was 3-fold higher (SMR, 2.9) than the risk in the general population, indicating a significant increase of breast cancer in the Hodgkin lymphoma cohort (P<.001). Similar,2, 16, 17 lower,7 and higher12 risks have been reported in the literature. These variations in risk may be explained by differences in duration of
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