According to a recent article published in the Journal of the National Cancer Institute, the risk of developing breast cancer among women treated for Hodgkin’s lymphoma varies according to the specific type of treatment used for Hodgkin’s, the duration of time since the diagnosis of Hodgkin’s and the age of a patient. Women who have been previously diagnosed and treated for Hodgkin’s lymphoma are urged to speak with their physician regarding their individual risks of developing breast cancer, as well as about the benefits of a personalized screening program.

Hodgkin’s lymphoma is a cancer of the lymph system (a part of the immune or infection fighting system), which includes the blood vessels, bone marrow, lymph nodes and lymph vessels that are present throughout the body. It also includes organs such as the spleen, thymus and tonsils.

This cancer is characterized by the presence of the uncontrollable growth and division of atypical white blood cells (immune cells) that crowd lymph tissue, suppressing the formation and function of other cells normally found in this tissue.

Patients with Hodgkin’s lymphoma are treated with chemotherapy, which is often followed by radiation therapy to sites where cancer remains bulky. The chest is one area where radiation may be used, as lymph nodes in that region can be involved with the disease. Previous studies have indicated that survivors of Hodgkin’s lymphoma have a higher rate of developing breast cancer than those in the general population; however, specific variables which may increase a patient’s risk has not been well defined.

Recently, a multi-institution study was conducted in an attempt to define associations among women treated for Hodgkin’s that may increase the risk of developing breast cancer. This study included over 3,800 females who had been diagnosed at 30 years or younger with Hodgkin’s. These women had been diagnosed between 1965 and 1994.

Results indicated that specific variables had significant effects on the risk of developing breast cancer among these women:

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• Diagnosed and treated for Hodgkin’s at the age of 25 years or younger

• Radiation dose of 40 Gy or higher to the chest

• No alkylating agents (specific chemotherapy agents) in the treatment regimen

Women who were considered to be at a higher risk according to these variables experienced increased risks of developing breast cancer as they aged:

• At 35, the risk of developing breast cancer was 1.4%

• At 45, the risk of developing breast cancer was 11.1%

• At 55, the risk of developing breast cancer was 29%

The researchers concluded that women who were diagnosed and treated for Hodgkin’s lymphoma at the age of 25 years or younger, received chest radiation at a dose of 40 Gy or higher and did not receive alkylating agents in their treatment regimen and had a more advanced age at follow-up were at an increased risk of developing breast cancer.

Women who have been treated for Hodgkin’s lymphoma should speak with their physician regarding their individual risks of developing breast cancer as well as a life-long screening program for the early detection of breast cancer.

Reference: Travis L, Hill D, Dores G, et al. Cumulative Absolute Breast Cancer Risk for Young Women Treated for Hodgkin Lymphoma. Journal of the National Cancer Institute. 2005; 97: 1428-1437.

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