Breast cancer in women following supradiaphragmatic irradiation for Hodgkin's disease
Breast cancer in women following supradiaphragmatic irradiation for Hodgkin's disease
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DOI：
10.1159/000012035
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发表时间：
1999-01-01
期刊：
影响因子：
3.5
通讯作者：
Goss, PE
中科院分区：
文献类型：
--
作者：
Gervais-Fagnou, DD;Girouard, C;Goss, PE
目的：据报道，接受膈上放疗治疗霍奇金病 (HD) 的女性患乳腺癌 (BC) 的相对风险 (RR) 升高，尤其是年轻女性。我们进行了回顾性图表审查，以调查 BC 的发病率并描述这些病例的特征。根据这些结果，对该患者群体中乳腺癌的未来发病率进行了预测，并概述了监测策略。患者和方法：玛格丽特公主医院回顾了 1965 年至 1990 年的图表，其中包括接受膈上放射治疗 HD 的 30 岁以下女性。结果：在平均随访 12.3 年的 427 名女性中，有 15 名随后患上 BC。 BC 诊断时的中位年龄为 41 岁（范围：30-52），距照射的中位间隔为 17 年（9-25）。偏侧性均等，50%的肿瘤位于乳房内象限。两名女性患有双侧异时性肿瘤。在该队列中，BC 的 RR 为 10.6（95% 置信区间 5.8-17）。据预测，到 2000 年、2005 年和 2010 年，我们的患者群体中将分别有 22 例、32 例和 39 例 BC 病例。结论：与一般人群中的女性相比，接受 HD 辐射的年轻女性患 BC 的风险高出 10 倍。在这个特定的患者群体中，我们能够预测未来几年预计的 BC 病例数。希望改进的监测能够早期发现、及时治疗并改善这些高危女性的预后。
Purpose: In women treated with supradiaphragmatic irradiation for Hodgkin's disease (HD) the relative risk (RR) of breast cancer (BC) has been reported to be elevated, particularly in younger women. A retrospective chart review was conducted to investigate the incidence of BC and to describe the characteristics of these cases. Based on these results, predictions were made regarding the future incidence of breast cancer in this patient population, and surveillance strategies are outlined. Patients and Methods: Charts from 1965 through 1990 were reviewed at the Princess Margaret Hospital to include women less than or equal to 30 years who were treated with supradiaphragmatic irradiation for HD. Results: Of the 427 women with a mean follow-up of 12.3 years, 15 subsequently developed BC. The median age at BC diagnosis was 41 years (range: 30-52) and the median interval from irradiation was 17 years (9-25). Laterality was equally divided, and 50% of the tumors were located in the inner quadrant of the breast. Two women developed bilateral metachronous tumors. In this cohort, the RR of BC is 10.6 (95% confidence interval 5.8-17). It is predicted that in our patient population there will be a total of 22, 32, and 39 cases of BC by the years 2000, 2005, and 2010, respectively. Conclusion: Compared to women in the general population, young women irradiated for HD have a 10-fold higher risk of developing BC. In this specific patient group, we are able to predict the number of BC cases expected in the forthcoming years. Hopefully, improved surveillance will enable early detection, timely treatment, and improved prognosis for these at-risk women.