Risk of male breast cancer after Hodgkin lymphoma

Author:

de Vries Simone1,Krul Inge M.1,Schaapveld Michael1,Janus Cecile P. M.2ORCID,Rademakers Saskia E.3,Roesink Judith M.4,Nijziel Marten R.5ORCID,Bilgin Yavuz M.6,Aleman Berthe M. P.7,van Leeuwen Flora E.1

Affiliation:

1. 1Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

2. 2Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands

3. 3Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands

4. 4Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands

5. 5Department of Hemato-Oncology, Catharina Cancer Institute, Eindhoven, The Netherlands

6. 6Department of Internal Medicine, Adrz, Goes, The Netherlands

7. 7Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

Abstract

Abstract Female survivors of Hodgkin lymphoma (HL) treated with chest radiotherapy have a strongly increased risk of breast cancer (BC), but the treatment-specific BC risk in male survivors of HL has not been evaluated. We assessed BC risk in a cohort of 3077 male survivors of 5-year HL treated at age ≤51 years in 20 Dutch hospitals between 1965 and 2013. We estimated standardized incidence ratios (SIRs), absolute excess risks per 10 000 person-years, and cumulative BC incidences. After a 20-year median follow-up, we observed 8 cases of male with BC. Male survivors of HL experienced a 23-fold (95% confidence interval [CI], 10.1-46.0) increased BC risk compared with the general population, representing 1.6 (95% CI, 0.7-3.3) excess BC incidences per 10 000 person-years. The 20- and 40-year cumulative BC incidences after HL treatment were 0.1% (95% CI, 0.02-0.3) and 0.7% (95% CI, 0.3-1.4), respectively. Treatment with chest radiotherapy without alkylating chemotherapy yielded a strongly increased SIR (20.7; 95% CI, 2.5-74.8), which was not significantly different for chest radiotherapy and alkylating chemotherapy (41.1; 95% CI, 13.4-96.0). Males treated with chest radiotherapy and anthracyclines had an SIR of 48.1 (95% CI, 13.1-123.1). Two patients died from BC (median follow-up, 4.7 years). To ensure early diagnosis and treatment, clinicians should be alert to BC symptoms in male survivors of HL.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

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