Abstract
The risk of developing a secondary cancer after chest radiation therapy (CRT), largely used to treat malignancies, in particular, Hodgkin lymphoma (HL), is higher than that of the general population. Breast cancers (BCs) are the most common female solid tumors in survivors of HL, with 8.23 relative risk and onset at a younger age (40 versus 61 years) in comparison with the general female population, so that in these women the BC risk is similar to that in BRCA mutation carriers. A positive correlation with the radiation dose and an inverse correlation with age at HL diagnosis were observed. The most common pathological BC subtype is invasive ductal, estrogen receptor negative, and triple negative, but a high frequency of ductal carcinoma in situ (DCIS) up to 50% was reported. The most frequent locations are the upper outer quadrants, within or at the margin of the CRT field. At mammography, BCs mostly appear as irregular masses and differently from BRCA mutation carriers microcalcifications have been reported in 25% of the cases. Several medical bodies recommend a surveillance based on annual mammography and MRI, with different thresholds for CRT doses and different time intervals from CRT to the start of surveillance. The Children’s Oncology Group recommends annual mammography plus MRI screening since 8 years after CRT or at 25 years of age, whichever occurs last. The use of mammography as adjunct to MRI is based on the following: MRI sensitivity is lower (63–80%) and that of mammography is higher (67–70%) than those observed in women with hereditary BC predisposition, due to a higher incidence of DCIS with microcalcifications and low neoangiogenesis in lymphoma survivors. A sensitivity close to 95% can be obtained only by combining both tests.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- ACS :
-
American Cancer Society
- BC:
-
Breast cancer
- BI-RADS :
-
Breast Imaging Reporting and Data System
- COG :
-
Children’s Oncology Group
- CRT :
-
Chest radiation therapy
- DBT :
-
Digital breast tomosynthesis
- DCIS :
-
Ductal carcinoma in situ
- ER :
-
Estrogen receptor
- EUSOMA :
-
European Society of Breast Cancer Specialists
- HER2:
-
Human epidermal growth factor receptor 2
- HL :
-
Hodgkin lymphoma
- MRI :
-
Magnetic resonance imaging
- NCCN :
-
National Comprehensive Cancer Network
- RR :
-
Relative risk
- SIRM :
-
Italian Society of Medical Radiology
References
Mariscotti G, Belli P, Bernardi D et al (2016) Mammography and MRI for screening women who underwent chest radiation therapy (lymphoma survivors): recommendations for surveillance from the Italian College of Breast Radiologists by SIRM. Radiol Med 121:834–837
Koo E, Henderson MA, Dwyer M, Skandarajah AR (2015) Management and prevention of breast cancer after radiation to the chest for childhood, adolescent, and young adulthood malignancy. Ann Surg Oncol 22(Suppl 3):S545–S451
Giri S, Pathak R, Martin MG, Bhatt VR (2015) Incidence of breast cancer among female survivors of Hodgkin lymphoma: a US-population-based trend analysis from 1973 to 2011. Blood 126:1861–1863
Schaapveld M, Aleman BM, van Eggermond AM et al (2015) Second cancer risk up to 40 years after treatment for Hodgkin’s lymphoma. N Engl J Med 373:2499–2511
Barthel EM, Spencer K, Banco D, Kiernan E, Parsons S (2016) Is the adolescent and young adult cancer survivor at risk for late effects? It depends on where you look. J Adolesc Young Adult Oncol 5(2):159–173
LeMieux MH, Solanki AA, Mahmood U, Chmura SJ, Koshy M (2015) Risk of second malignancies in patients with early-stage classical Hodgkin’s lymphoma treated in a modern era. Cancer Med 4(4):513–518
Ibrahim EM, Abouelkhair KM, Kazkaz GA, Elmasri OA, Al-Foheidi M (2012) Risk of second breast cancer in female Hodgkin’s lymphoma survivors: a meta-analysis. BMC Cancer 12:197
Moskowitz CS, Chou JF, Wolden SL et al (2014) Breast cancer after chest radiation therapy for childhood cancer. J Clin Oncol 32:2217–2223
De Bruin ML, Sparidans J, van’t Veer MB et al (2009) Breast cancer risk in female survivors of Hodgkin’s lymphoma: lower risk after smaller radiation volumes. J Clin Oncol 27:4239–4246
Henderson TO, Amsterdam A, Bhatia S et al (2010) Systematic review: surveillance for breast cancer in women treated with chest radiation for childhood, adolescent, or young adult cancer. Ann Intern Med 152(444–455):W144–W154
Cutuli B, Kanoun S, Tunon De Lara C et al (2012) Breast cancer occurred after Hodgkin’s disease: clinico-pathological features, treatments and outcome: analysis of 214 cases. Crit Rev Oncol Hematol 81:29–37
Allen SD, Wallis MG, Cooke R, Swerdlow AJ (2014) Radiologic features of breast cancer after mantle radiation therapy for Hodgkin disease: a study of 230 cases. Radiology 272:73–78
Kwong A, Hancock SL, Bloom JR et al (2008) Mammographic screening in women at increased risk of breast cancer after treatment of Hodgkin’s disease. Breast J 14:39–48
Tieu MT, Cigsar C, Ahmed S et al (2014) Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging. Cancer 120:2507–2513
Freitas V, Scaranelo A, Menezes R, Kulkarni S, Hodgson D, Crystal P (2013) Added cancer yield of breast magnetic resonance imaging screening in women with a prior history of chest radiation therapy. Cancer 119:495–503
Ng AK, Garber JE, Diller LR et al (2013) Prospective study of the efficacy of breast magnetic resonance imaging and mammographic screening in survivors of Hodgkin lymphoma. J Clin Oncol 31:2282–2288
Sung JS, Lee CH, Morris EA, Oeffinger KC, Dershaw DD (2011) Screening breast MR imaging in women with a history of chest irradiation. Radiology 259:65–71
Sardanelli F, Boetes C, Borisch B et al (2010) Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer 46:1296–1316
Saslow D, Boetes C, Burke W et al (2007) American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin 57:75–89
Children’s Oncology Group (2014) Long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers. Version 4.0. https://childrensoncologygroup.org/index.php/survivorshipguidelines. Accessed 14 May 2020
National Comprehensive Cancer Network. NCCN guidelines. https://www.nccn.org. Accessed 14 May 2020
American College of Radiology (2013) Breast Imaging Reporting and Data System® (BI-RADS®). 5th edition. American College of Radiology, Reston, VA, USA
Sardanelli F, Podo F, Santoro F et al (2011) Multicenter surveillance of women at high genetic breast cancer risk using mammography, ultrasonography, and contrast-enhanced magnetic resonance imaging (the high breast cancer risk Italian 1 study): final results. Investig Radiol 46:94–105
Phi XA, Saadatmand S, De Bock GH et al (2016) Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis. Br J Cancer 114:631–637
Oeffinger KC, Ford JS, Moskowitz CS et al (2009) Breast cancer surveillance practices among women previously treated with chest radiation for a childhood cancer. JAMA 301:404–414
Elkin EB, Klem ML, Gonzales AM et al (2011) Characteristics and outcomes of breast cancer in women with and without a history of radiation for Hodgkin’s lymphoma: a multi-institutional, matched cohort study. J Clin Oncol 29:2466–2473
Hodgson DC, Cotton C, Crystal P, Nathan PC (2016) A mathematical model of BC development was used to evaluate the marginal benefit of early-initiated screening. J Natl Cancer Inst 108(7)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Trimboli, R.M., Mariscotti, G. (2020). The Special Case of Previous Chest Radiation Therapy. In: Sardanelli, F., Podo, F. (eds) Breast MRI for High-risk Screening. Springer, Cham. https://doi.org/10.1007/978-3-030-41207-4_14
Download citation
DOI: https://doi.org/10.1007/978-3-030-41207-4_14
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-41206-7
Online ISBN: 978-3-030-41207-4
eBook Packages: MedicineMedicine (R0)