Breast cancer risk following Hodgkin lymphoma radiotherapy in relation to menstrual and reproductive factors - PubMed (original) (raw)

. 2013 Jun 11;108(11):2399-406.

doi: 10.1038/bjc.2013.219. Epub 2013 May 7.

M E Jones, D Cunningham, S J Falk, D Gilson, B W Hancock, S J Harris, A Horwich, P J Hoskin, T Illidge, D C Linch, T A Lister, H H Lucraft, J A Radford, A M Stevens, I Syndikus, M V Williams; England and Wales Hodgkin Lymphoma Follow-up Group; A J Swerdlow

Collaborators, Affiliations

Breast cancer risk following Hodgkin lymphoma radiotherapy in relation to menstrual and reproductive factors

R Cooke et al. Br J Cancer. 2013.

Abstract

Background: Women treated with supradiaphragmatic radiotherapy (sRT) for Hodgkin lymphoma (HL) at young ages have a substantially increased breast cancer risk. Little is known about how menarcheal and reproductive factors modify this risk.

Methods: We examined the effects of menarcheal age, pregnancy, and menopausal age on breast cancer risk following sRT in case-control data from questionnaires completed by 2497 women from a cohort of 5002 treated with sRT for HL at ages <36 during 1956-2003.

Results: Two-hundred and sixty women had been diagnosed with breast cancer. Breast cancer risk was significantly increased in patients treated within 6 months of menarche (odds ratio (OR) 5.52, 95% confidence interval (CI) (1.97-15.46)), and increased significantly with proximity of sRT to menarche (Ptrend<0.001). It was greatest when sRT was close to a late menarche, but based on small numbers and needing reexamination elsewhere. Risk was not significantly affected by full-term pregnancies before or after treatment. Risk was significantly reduced by early menopause (OR 0.55, 95% CI (0.35-0.85)), and increased with number of premenopausal years after treatment (Ptrend=0.003).

Conclusion: In summary, this paper shows for the first time that sRT close to menarche substantially increases breast cancer risk. Careful consideration should be given to follow-up of these women, and to measures that might reduce their future breast cancer risk.

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