Reirradiation in a patient with breast carcinoma after Hodgkin’s lymphoma
DOI:
https://doi.org/10.11606/issn.1679-9836.v100i2p178-183Keywords:
Radiation-induced malignancies, Breast cancer, Hodgkin’s lymphomaAbstract
The long-term survival of the Hodgkin’s lymphoma patients treated at an early age with chemoradiotherapy is raising awareness for the late effects of this treatment. Radio-induced breast cancer is one of the described risks and occurs almost exclusively after a period of 10 years. Well-established risk factors include the diagnosis in the 10-16 age group, the use of extended-field radiation therapy and an increase in radiation dose. Conservative breast surgery with adjuvant radiotherapy is feasible, but dose-reduction techniques to organs at risk should be considered, given the previous irradiation. We report a clinical case of a secondary breast cancer in a patient who underwent chemoradiotherapy, with mantle field radiation therapy, for supradiaphragmatic Hodgkin’s lymphoma at youth. After multidisciplinary discussion and given the patient’s willingness to preserve the breast, she was treated with conservative breast surgery and adjuvant radiotherapy.
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References
Radiotherapy: developing a world class service for England. Report to Ministers from National Radiotherapy Advisory Group; 2007.
Olszewski AJ, Shrestha R, Castillo JJ. Treatment selection and outcomes in early-stage classical Hodgkin lymphoma: analysis of the National Cancer Data Base. J Clin Oncol. 2015;33(6):625-33. doi: 10.1200/JCO.2014.58.7543.
Eichenauer DA, Aleman BMP, André M, Federico M, Hutchings M, Illidge T, et al. Hodgkin lymphoma: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-up. Ann Oncol. 2018;29(Suppl 4):19-29.. doi: https://doi.org/10.1093/annonc/mdy080.
Bhatia S, Yasui Y, Robison LL, Birch JM, Bogue MK, Diller L, et al. High risk of subsequent neoplasms continues with extended follow-up of childhood Hodgkin’s disease: report from the Late Effects Study Group. J Clin Oncol. 2003;21(23):4386-94. doi: 10.1200/JCO.2003.11.059.
Ng AK. Current Survivorship Recommendations for patients with Hodgkin lymphoma: focus on late effects. Blood. 2014;124(23):3373-9. doi: 10.1182/blood-2014-05-579193.
Swerdlow AJ, Higgins CD, Smith P, Cunningham D, Hancock BW, Horwich A, et al. Second cancer risk after chemotherapy for Hodgkin’s lymphoma: a collaborative British Cohort Study. J Clin Oncol. 2011;29(31):4096-104. doi: 10.1200/JCO.2011.34.8268.
Franklin, J, PluetschowA, Paus M, Specht L, Anselmo A-P, Aviles A, et al. Second malignancy risk associated with treatment of Hodgkin’s lymphoma: meta-analysis of the randomised trials. Ann Oncol. 2006;17(12):1749-60. doi: 10.1093/annonc/mdl302.
Schaapveld M, Aleman BMP, van Eggermond AM, Janus CPM, Krol ADG, van der Maazen RWM, et al. Second Cancer Risk Up to 40 Years after treatment for Hodgkin’s lymphoma. New Engl J Med. 2015;373(26):2499-511. doi: 10.1056/NEJMoa1505949.
Conway JL, Connors JM, Tyldesley S, Savage KJ, Campbell BA, Zheng YY, et al. Secondary breast cancer risk by radiation volume in women with Hodgkin lymphoma. Int J Radiat Oncol Biol Phys. 2016;97(1):35-41. doi: 10.1016/j.ijrobp.2016.10.004.
National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Hodgkin lymphoma, Version 3.2018 - April 16, 2018 [cited 2018 Sept 15]. Available form: http://www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf.
Nieder C, Schill S, Kneschaurek P, Molls M, et al. Comparison of three different mediastinal radiotherapy techniques in female patients: impact on heart sparing and dose to the breasts. Radiother Oncol. 2007;82(3):301-7. doi: 10.1016/j.radonc.2006.10.015.
Krul IM, van Winden AWJO, Aleman BMP, Janus CPM, van Eggermond AM, De Bruin ML, et al. Breast cancer risk after radiation therapy for Hodgkin lymphoma: influence of gonadal hormone exposure. Int J Radiat Oncol Biol Phys. 2017;99(4):843-53. doi: 10.1016/j.ijrobp.2017.07.016.
AlmEl-Din MA, Hughes KS, Raad RA, Goldberg SI, Aisenberg AC, Niemierko A, et al. Clinical outcome of breast cancer occurring after treatment for Hodgkin’s lymphoma: case-control analysis. Radiat Oncol. 2009:4(1):19. doi: 10.1186/1748-717X-4-19.
Horst KC, Hancock SL, Ognibene G, Chen C, Advani RH, Rosenberg SA, et al. Histologic subtypes of breast cancer following radiotherapy for Hodgkin lymphoma. Ann Oncol. 2014;25(4):848-51. doi: 10.1093/annonc/mdu017.
Best T, Li D, Skol AD, Kirchhoff T, Jackson SA, Yasui Y, et al. Variants at 6q21 implicate PRDM1 in the etiology of therapy-induced second malignancies after Hodgkins lymphoma. Nature Med. 2011;17(8):941-3. doi: 10.1038/nm.2407.
Nichols KE, Heath JA, Friedman D, Biegel JA, Ganguly A, Mauch P, Diller L. TP53, BRCA1, and BRCA2 tumor suppressor genes are not commonly mutated in survivors of Hodgkin’s disease with second primary neoplasms. J Clin Oncol. 2003;21(24):4505-9. doi: 10.1200/JCO.2003.12.042.
Ng AK, Garber JE, Diller LR, Birdwell RL, Feng Y, Neuberg DS, et al. Prospective study of the efficacy of breast magnetic resonance imaging and mammographic screening in survivors of Hodgkin lymphoma. J Clin Oncol. 2013;31(18):2282-8. doi: 10.1200/JCO.2012.46.5732.
Watson P, Peterson B, Lee C, Baxstrom K, Turcotte L, Vogel R, et al. A pilot study evaluating chemotherapy tolerability for breast cancer patients who have received prior treatment and chest radiation for Hodgkin lymphoma. Cancer Treat Res Commun. 2018;15:1-6. doi: 10.1016/j.ctarc.2018.02.001.
Wong RK, Morrison SD, Momeni A, Nykiel M, Lee GK. Outcomes of breast reconstruction in breast cancer patients with a history of mantle radiation for Hodgkin lymphoma. Ann Plastic Surg. 2014;72. doi: 10.1097/SAP.0000000000000167
Haberer S, Belin L, Le Scodan R, Kirova YM, Savignoni A, Stevens D, et al. Locoregional treatment for breast carcinoma after Hodgkin’s lymphoma: the breast conservation option. Int J Radiat Oncol Biol Phys. 2012;82(2). doi: 10.1016/j.ijrobp.2011.03.013.
Intra M, Mattar D, Sangalli C, Rotmensz N, Viale G, Galimberti, V, et al. Local therapy for breast cancer in malignant lymphoma survivors. Breast. 2011;20(3):99-103. doi: 10.1016/S0960-9776(11)70304-6.
Blandino G, Guenzi M, Belgioia L, Bonzano E, Configliacco E, Tornari E, et al. Adjuvant intraoperative radiotherapy for selected breast cancers in previously irradiated women: evidence for excellent feasibility and favourable outcomes. Rep Pract Oncol Radiother. 2017;22(4):277-83. doi: 10.1016/j.rpor.2017.02.009.
Wolden SL, Hancock SL, Carlson RW, Goffinet DR, Jeffrey SS and Hoppe RT. Management of breast cancer after Hodgkin’s disease. J Clin Oncol. 2000;18(4):765. doi: 10.1200/JCO.2000.18.4.765.
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Copyright (c) 2021 André Filipe Pinheiro Figueiredo, Diogo de Carvalho Miranda e Silva Delgado, Vera Margarida de Azevedo Andrade Arnaut Mendonça, Marília Maria Liberato Jorge Lemos
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