title: Management of breast cancer after Hodgkin's lymphoma and paediatric cancer.
abstract: BACKGROUND
  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.
  
  
  METHODS
  The study concerns women with a history of primary neoplasms treated with chest irradiation ± chemotherapy and subsequently diagnosed with BC.
  
  
  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.
  
  
  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.
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. Electronic address: monica.terenziani@istitutotumori.mi.it.
authors.forename: M
authors.initials: M
authors.lastname: Terenziani
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Massimino
authors.affiliation: Fondazione Michelangelo, Milano, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Magazzù
authors.affiliation: Radiotherapy Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Gandola
authors.affiliation: Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Capri
authors.affiliation: Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: Carcangiu
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Catania
authors.affiliation: Radiotherapy Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Di Russo
authors.affiliation: Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Gennaro
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Meazza
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Podda
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Schiavello
authors.affiliation: Fondazione Michelangelo, Milano, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Valagussa
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D015412:Mastectomy, Segmental / Q000009:adverse effects / Q000401:mortality; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Breast cancer; Hodgkin’s lymphoma; Paediatric cancer