Hodgkin's Survivors Prone to Breast Cancer Later

Feb. 17 -- MONDAY, Feb. 16 (HealthDay News) -- In an ironic testament to the success of childhood cancer treatments, researchers report that women who were treated as children with radiation for Hodgkin's disease were almost 40 times more likely to develop breast cancer later in life.

"We can cure most patients now who have Hodgkin's disease. Back in 1950, it was regarded as a universally fatal disease," said study co-author Dr. Nancy Mendenhall, a professor of radiation oncology at the University of Florida College of Medicine in Gainesville. "[But] when you've got a high cure rate, as people age, you begin to identify some of the unanticipated effects that seem to be related to the treatments. If you don't cure the patients, they don't survive to see those effects."

The risk rose with the radiation dose, and there was also a higher risk of developing malignancies in both breasts.

The findings, published in the September issue of The International Journal of Radiation Oncology Biology Physics, are part of a larger study involving 930 children treated for Hodgkin's disease between 1960 and 1990 at five U.S. centers. Overall, survivors of childhood Hodgkin's disease, especially female survivors, were found to be at higher risk for second malignancies.

Often treatment for Hodgkin's involves radiation to the breast area, so some amount of breast tissue receives some amount of radiation, explained study leader Dr. Louis S. Constine, a professor of radiation oncology at the James P. Wilmot Cancer Center, University of Rochester Medical Center.

The amounts of radiations used are much lower than in the past, Constine added, as is the proportion of the body irradiated. Chemotherapy is also sometimes substituted for radiation in more modern treatment.

This analysis followed almost 400 female survivors of childhood Hodgkin's disease for an average of almost 17 years.

Women who had had this childhood cancer were 37 times more likely to develop breast cancer as compared to women who had not had Hodgkin's disease, although the absolute risk was low (29 women overall were diagnosed with breast cancer). Women were diagnosed as early as 9.4 years after radiation and as late as 36.1 years after the initial treatment. More women are likely to be diagnosed with breast cancer as follow-up continues.