霍奇金淋巴瘤治疗后发生乳腺癌的临床结局：病例对照分析

Clinical outcome of breast cancer occurring after treatment for Hodgkin's lymphoma: case-control analysis.

作者信息

Alm El-Din Mohamed A, Hughes Kevin S, Raad Rita A, Goldberg Saveli I, Aisenberg Alan C, Niemierko Andrzej, Taghian Alphonse G

机构信息

Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

出版信息

Radiat Oncol. 2009 Jun 30;4:19. doi: 10.1186/1748-717X-4-19.

DOI:10.1186/1748-717X-4-19

PMID:19566943

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2715416/

Abstract

BACKGROUND

To evaluate diagnosis, management and outcome of breast cancer (BC) occurring after irradiation for Hodgkin's lymphoma (HL).

METHODS

39 cases of BC in 28 HL survivors were retrospectively reviewed. 21 patients were included in a case-control analysis.

RESULTS

The median age at diagnosis of HL and BC was 25.3 and 45.3 years, respectively. The median interval to develop BC was 16.1 years. Eleven women (39.2%) had bilateral disease. Mode of detection of the index breast cancers was by mammographic screening in 17 patients (60.7%), palpable lump in 8 patients (28.6%), clinical examination in two patients (7.1%), and unknown in one patient (3.6%). Case-control analysis showed that histological features and prognosis of BC after HL were similar to those of primary BC, however, for BC after HL, mastectomy was the predominant surgery (P = .001) and adjuvant radiotherapy and anthracycline-based chemotherapy were less frequently used as compared to primary BC (P < .001 and .003, respectively).

CONCLUSION

The previous history of HL does not appear to be a poor prognostic factor for BC occurring thereafter.

摘要

背景

评估霍奇金淋巴瘤（HL）放疗后发生乳腺癌（BC）的诊断、管理及预后。

方法

回顾性分析28例HL幸存者中的39例BC病例。21例患者纳入病例对照分析。

结果

HL和BC诊断时的中位年龄分别为25.3岁和45.3岁。发生BC的中位间隔时间为16.1年。11名女性（39.2%）为双侧病变。索引乳腺癌的检测方式为：17例患者（60.7%）通过乳腺钼靶筛查，8例患者（28.6%）通过可触及肿块，2例患者（7.1%）通过临床检查，1例患者（3.6%）检测方式不明。病例对照分析显示，HL后BC的组织学特征和预后与原发性BC相似，然而，对于HL后的BC，乳房切除术是主要手术方式（P = 0.001），与原发性BC相比，辅助放疗和基于蒽环类药物的化疗使用频率较低（分别为P < 0.001和0.003）。