Karasek K, Deutsch M
Department of Radiation Oncology, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Am J Clin Oncol. 1996 Oct;19(5):451-4. doi: 10.1097/00000421-199610000-00005.
Six women received irradiation for lymphoma (Hodgkin's disease, n = 5; non-Hodgkin's disease, n = 1) to at least a mediastinal field (n = 2) or to a mantle field (n = 4), and subsequently developed breast cancer 10-27 years later. Three patients also received chemotherapy as a component of therapy for lymphoma. For breast cancer, all were treated with lumpectomy and breast irradiation to 5,000 cGy in 25 fractions plus a 1,000 cGy/5 fraction boost to the operative area using electrons. Two patients received adjuvant chemotherapy and three others tamoxifen for breast cancer. All women are alive and free of disease 15-118 months (median, 60 months) following breast irradiation. There have been no cases of significant acute reactions and no late sequelae such as skin pigmentation changes subcutaneous fibrosis, rib fractures, cardiac disease, or pulmonary fibrosis. The cosmetic result is considered good or excellent in all. Lumpectomy and breast irradiation is not contraindicated in the woman who develops breast cancer many years after irradiation of lymph node regions above the diaphragm for lymphoma.
6名女性因淋巴瘤（霍奇金病5例，非霍奇金病1例）接受了至少纵隔野（2例）或斗篷野（4例）的照射，随后在10至27年后发生乳腺癌。3例患者还接受了化疗作为淋巴瘤治疗的一部分。对于乳腺癌，所有患者均接受了肿块切除术，并给予25次分割照射至5000 cGy，外加使用电子线对手术区域给予1000 cGy/5次分割的加量照射。2例患者接受了辅助化疗，另外3例接受了他莫昔芬治疗乳腺癌。所有女性在乳腺照射后15至118个月（中位时间60个月）均存活且无疾病。未出现明显的急性反应病例，也没有出现如皮肤色素沉着改变、皮下纤维化、肋骨骨折、心脏病或肺纤维化等晚期后遗症。所有患者的美容效果均被认为良好或极佳。对于因淋巴瘤接受膈肌以上淋巴结区域照射多年后发生乳腺癌的女性，肿块切除术和乳腺照射并无禁忌。
