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Management of breast cancer after Hodgkin's lymphoma and paediatric cancer.
- Source :
-
European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 2015 Sep; Vol. 51 (13), pp. 1667-74. Date of Electronic Publication: 2015 Jun 16. - Publication Year :
- 2015
-
Abstract
- Rationale: The risk of women developing a breast cancer (BC) after receiving chest radiotherapy for paediatric cancers and Hodgkin lymphomas is well established. The aim of this study was to assess these patients' clinical characteristics and clinical outcomes.<br />Methods: The study concerns women with a history of primary neoplasms treated with chest irradiation ± chemotherapy and subsequently diagnosed with BC.<br />Results: We identified 78 women who developed BC (invasive in 68 cases, 87%). They were a median 18 and 38 years of age when their first neoplasm and BC were diagnosed, respectively. Breast-conserving surgery was performed in 39 patients, and 32 underwent breast irradiation. Twenty of the 41 patients (49%) treated with chemotherapy received an anthracycline-containing regimen. The 5- and 11-year event free survival (EFS) and overall survival (OS) rates were 69% and 42%, respectively. Nine patients (12%) developed a third cancer and 18 (23%) a cardiovascular event. Of the 68 women with invasive BC, the first event involved contralateral BC in 55% of cases: time to progression (TTP) rates were 70% and 47% at 5 and 11 years. The 5- and 11-year BC-specific survival rates (BCSS) were 84% and 68%, respectively.<br />Conclusions: Judging from our experience, survival rates after BC developing in women previously given chest radiotherapy are not dissimilar to those observed in other women with primary BC. Given the far from negligible risk of subsequent cancers and cardiovascular events, it is mandatory to discuss the best choice of treatment for such patients in terms of their chances of cure and quality of life, and also the risks of late sequelae.<br /> (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adolescent
Adult
Age Factors
Aged
Antineoplastic Combined Chemotherapy Protocols adverse effects
Breast Neoplasms diagnosis
Breast Neoplasms etiology
Breast Neoplasms mortality
Chemotherapy, Adjuvant
Child
Child, Preschool
Disease Progression
Disease-Free Survival
Female
Humans
Italy
Kaplan-Meier Estimate
Middle Aged
Neoadjuvant Therapy
Neoplasms, Radiation-Induced diagnosis
Neoplasms, Radiation-Induced etiology
Neoplasms, Radiation-Induced mortality
Radiotherapy adverse effects
Radiotherapy, Adjuvant
Risk Assessment
Risk Factors
Survival Rate
Time Factors
Treatment Outcome
Young Adult
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Breast Neoplasms therapy
Hodgkin Disease radiotherapy
Mastectomy, Segmental adverse effects
Mastectomy, Segmental mortality
Neoplasms, Radiation-Induced therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0852
- Volume :
- 51
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- European journal of cancer (Oxford, England : 1990)
- Publication Type :
- Academic Journal
- Accession number :
- 26092639
- Full Text :
- https://doi.org/10.1016/j.ejca.2015.05.024