In Hodgkin Lymphoma survivors, it is not only radiotherapy that increases the risk of breast cancer – beware of doxorubicin.
Piotr J. Wysocki
MD, PhD, medical oncologist; Professor of Medicine, Head of Department of Oncology, Jagiellonian University Hospital. ASCO International Affairs Committee member
In a cohort of 1,964 female Hodgkin lymphoma (HL) 5-year survivors treated at age 15-50 years between 1975-2008 in the Netherlands, Dutch researchers analyzed the impact of doxorubicin on the risk of breast cancer (BC). (Neppelenbroek SIM et al. J Clin Oncol 2024)
With a median follow-up of approx. 21 years, 252 women were diagnosed with in situ or invasive BC. The 30-year cumulative BC incidence was 20.8%. The cumulative doxorubicin dose of >200 mg/m2 was associated with a 1.5-fold increased BC risk compared with HL survivors not treated with doxorubicin, and the risk significantly increased by 1.18-fold per each additional 100 mg/m2 of doxorubicin.
This analysis clearly shows that even HL patients who have not undergone mantle field irradiation but have been treated with standard doxorubicin-based chemotherapy are at significantly increased risk of BC development. Therefore, risk-optimized BC screening should be performed in HL survivors. ?