title: [Breast conserving surgery in locoregional treatment of breast carcinoma after Hodgkin lymphoma].
abstract: OBJECTIVE
  To report characteristics and outcome of breast cancer after irradiation for Hodgkin lymphoma with special focus on breast conservation surgery.
  
  
  METHODS
  Medical records of 72 women who developed either ductal carcinoma in situ or stage I-III invasive carcinoma of the breast after Hodgkin lymphoma between 1978 and 2009 were retrospectively reviewed.
  
  
  RESULTS
  Median age at Hodgkin lymphoma diagnosis was 23 years old. Median total dose received by the mediastinum was 40 Gy, mostly by a mantle field technique. Breast cancer occurred after a median time interval of 21 years. Ductal invasive carcinoma and ductal carcinoma in situ represented respectively 71% and 19% of the cases. Locoregional treatment for breast cancer consisted of mastectomy with or without radiotherapy in 39 patients and of lumpectomy with or without adjuvant radiotherapy in 32 patients. The isocentric lateral decubitus radiation technique was used in 17 patients after breast conserving surgery (57%). With a median follow-up of 7 years, 5-year overall survival rate and locoregional control rate were respectively 74.5% and 82% for invasive carcinoma and 100% and 92% for in situ carcinoma. Thirteen patients died of progressive breast cancer and contralateral breast cancer was diagnosed in ten patients (14%).
  
  
  CONCLUSIONS
  Breast conserving treatment can be an option for breast cancers that occur after Hodgkin lymphoma despite prior thoracic irradiation. It should consist of lumpectomy and adjuvant breast radiotherapy with use of adequate techniques, such as the lateral decubitus isocentric position.
authors.affiliation: Département de radiothérapie, institut Curie, Paris, France. Sophie.haberer@wanadoo.fr
authors.forename: S
authors.initials: S
authors.lastname: Haberer
authors.forename: L
authors.initials: L
authors.lastname: Belin
authors.forename: R
authors.initials: R
authors.lastname: Le Scodan
authors.forename: Y M
authors.initials: YM
authors.lastname: Kirova
authors.forename: A
authors.initials: A
authors.lastname: Savignoni
authors.forename: D
authors.initials: D
authors.lastname: Stevens
authors.forename: P
authors.initials: P
authors.lastname: Moisson
authors.forename: D
authors.initials: D
authors.lastname: Decaudin
authors.forename: J-Y
authors.initials: JY
authors.lastname: Pierga
authors.forename: F
authors.initials: F
authors.lastname: Reyal
authors.forename: F
authors.initials: F
authors.lastname: Campana
authors.forename: A
authors.initials: A
authors.lastname: Fourquet
authors.forename: M A
authors.initials: MA
authors.lastname: Bollet
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D002277:Carcinoma / Q000601:surgery*; D005260:Female; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult