Mammographic Screening in Women at Increased Risk of Breast Cancer after Treatment of Hodgkin's Disease

Ava Kwong, Steven L. Hancock, Joan R. Bloom, Sunita Pal, Robyn L. Birdwell, Carol Mariscal, Debra M. Ikeda
The Breast Journal Volume 14 Issue 1 Page 39-48, January/February 2008

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Treatment regimens for Hodgkin’s disease (HD) that have included radiation to lymph node regions in the thorax have contributed to high rates of long-term disease-free survival. However, incidental radiation exposure of breast tissue in young women has significantly increased the risk of breast cancer compared to expected rates in the general population. After informing patients about risks associated with previous treatment of HD, we studied screening mammograms and call-back rates in women at increased risk for developing breast cancer at a younger age.

Women who have had thoracic nodal irradiation for Hodgkin’s disease have an increased risk of developing secondary breast cancer at an unusually young age. As expected in younger women, high density breast tissue was common on mammography, and the recall and biopsy rates were unusually high. However, early mammographic screening facilitated diagnosis of in situ and early invasive cancer in 3.5% of our subjects.