Breast carcinoma in women previously treated for Hodgkin's disease:: clinical and mammographic findings

The aim of this study was to describe the radiological characteristics of breast cancers occurring after treatment of Hodgkin's disease (HD), This study identified 23 women (age range 28-70 years, mean age 40 years) with 29 breast cancers (22 infiltrating carcinomas, 5 in situ, 1 sarcoma, I indeterminate) who had previously undergone mantle irradiation (35-40 Gy) for HD. Clinical and mammographic data were reviewed by two radiologists. Dosimetry was available for 16 patients. Time from treatment of HD to the occurrence of breast cancer ranged from 15 months to 35 years (mean 18 years); 79% were younger than 45 years and 76 % of cancers occurred between 10 and 25 years of follow-up. The physical examination was positive in 76% and 6 patients had bilateral tumors (synchronous, n = 2; metachronous, n = 4), Eighty-three percent of mammograms (n = 24) were abnormal (microcalcifications, n = 72 %; opacity, n = 54 %; two inflammatory breast cancers). Seven cancers were only detected by mammography. but mammograms were normal in 4 patients. Breast cancer was located beyond or was overlapping radiation fields In 75 % of cases. Starting 10 years after mantle irradiation of woman with HD, the follow-up should include annual clinical breast examination and mammography.