Hodgkin Lymphoma Treatment May Boost Breast Cancer Risks

Breast cancer screening should begin early for young Hodgkin lymphoma survivors

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) The vast majority of children who develop Hodgkin lymphoma beat the blood cancer after treatment, which includes powerful radiation. A new study looked at how that therapy affected young patients later in life.

Girls over the age of 9 who were treated for Hodgkin lymphoma had an increased risk of developing breast cancer as young women, a new long-term study has discovered.

These findings suggest that young adult women who were treated for Hodgkin lymphoma as children should be monitored closely for breast cancer, according to the authors of this study.

"If your child has ongoing night sweats, see your pediatrician."

Günther Schellong, MD, led this observational study on behalf of the German Working Group on the Long-Term Sequelae of Hodgkin’s Disease. The research was designed to look at the long-term effects of treating Hodgkin lymphoma (also known as Hodgkin’s disease).

Hodgkin lymphoma makes up about 4 percent of the nearly 11,500 childhood cancers that occur in the US every year. The childhood form of this cancer usually starts in the lymph nodes (part of the immune system) of the neck or behind the lungs.

Hodgkin lymphoma is treated with a combination of chemotherapy and radiation therapy. And these treatments can save lives, with the five-year survival rate for youngsters being 96 percent.

This study included 590 girls who were treated for Hodgkin lymphoma as girls and adolescents between 1978 and 1995.

Dr. Schellong’s team followed these young women until July 2012, by which time 26 of the 590 participants had developed breast cancer. Here’s what the researchers learned:

  • Participants had been treated for Hodgkin lymphoma between the ages of 9.9 and 16.2 years — what’s known as the “pubertal phase” of development.
  • The median time between Hodgkin lymphoma treatment and breast cancer diagnosis was 20.7 years.
  • The median age of the women diagnosed with breast cancer was 35.3 years
  • The youngest Hodgkin lymphoma survivor diagnosed with breast cancer was 26.8 years old.

“For women aged 25 to 45 in this series, the frequency of breast cancer was 24 times as high as in the corresponding normal population,” the study's authors wrote.

Based on these findings, the researchers suggested that extra care be taken when treating young girls for Hodgkin lymphoma. “In particular, when supradiaphragmatic [above the diaphragm] radiotherapy is necessary in girls over the age of  9, the extent of irradiated parts of the breast should be kept as small as can be medically justified.”

Alexis Harvey, MD, medical Director of the NJ Region of 21st Century Oncology, has treated girls who later developed breast cancer. Dr. Harvey told dailyRx News, “Screening for this patient population needs to be instituted at an early age, and the women need to be counseled regarding the need for consistent self-breast examinations. With new technology, the radiation treatments are tapered to the nodal sites only, but avoiding the breast is nearly impossible, and the increased breast cancer risk needs to be addressed.”

This study was published in the January issue of Deutsches Ärzteblatt International.

The research was funded by the German Childhood Cancer Foundation, the Children's Cancer Aid Ministery, Jens Brunken Foundation and the German Cancer Aid.

No financial conflicts of interest were reported.

Review Date: 
January 24, 2014
Last Updated:
January 27, 2014