Best practice & research clinical haematology: Screening for breast cancer in hodgkin lymphoma survivors

IF 2.2 4区 医学 Q3 HEMATOLOGY
Stephanie M. Wong
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Abstract

Childhood and young adult survivors of Hodgkin lymphoma are at an elevated risk of developing breast cancer. Breast cancer risk is felt to originate from chest wall radiation exposure prior to the third decade of life, with incidence beginning to rise approximately eight to ten years following Hodgkin lymphoma treatment. Although incidence varies according to age at radiation exposure, dosage, and treatment fields, cohort studies have documented a cumulative incidence of breast cancer of 10–20% by 40 years of age. Women with a history of chest radiation for Hodgkin lymphoma are counselled to begin screening with bilateral breast MRI at 25 years of age, or eight years after radiation, whichever occurs later. Outside of high-risk surveillance, the optimal management approach for women with prior radiation exposure continues to evolve. When diagnosed with breast malignancy, evidence supports consideration of unilateral therapeutic and contralateral prophylactic mastectomy, although breast conserving surgery may be considered following multidisciplinary assessment. This review will address the epidemiology, characteristics, screening and management guidelines, and breast-cancer prevention efforts for Hodgkin lymphoma survivors treated with radiation therapy in adolescence and young adulthood.

临床血液学的最佳实践与研究:霍奇金淋巴瘤幸存者的乳腺癌筛查
霍奇金淋巴瘤的儿童和青年幸存者患乳腺癌的风险较高。乳腺癌的风险被认为起源于30岁之前的胸壁辐射暴露,在霍奇金淋巴瘤治疗后大约8到10年发病率开始上升。尽管发病率因辐射暴露年龄、剂量和治疗领域而异,但队列研究表明,到40岁时,乳腺癌的累积发病率为10-20%。有胸部放射治疗霍奇金淋巴瘤病史的妇女,建议在25岁或放射治疗后8年(以较晚者为准)开始进行双侧乳房MRI筛查。在高风险监测之外,对既往有过辐射照射的妇女的最佳管理方法仍在不断发展。当诊断为乳腺恶性肿瘤时,证据支持考虑单侧治疗性和对侧预防性乳房切除术,尽管在多学科评估后可以考虑保乳手术。本综述将讨论在青春期和青年期接受放射治疗的霍奇金淋巴瘤幸存者的流行病学、特征、筛查和管理指南以及乳腺癌预防措施。
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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
42
审稿时长
35 days
期刊介绍: Best Practice & Research Clinical Haematology publishes review articles integrating the results from the latest original research articles into practical, evidence-based review articles. These articles seek to address the key clinical issues of diagnosis, treatment and patient management. Each issue follows a problem-orientated approach which focuses on the key questions to be addressed, clearly defining what is known and not known, covering the spectrum of clinical and laboratory haematological practice and research. Although most reviews are invited, the Editor welcomes suggestions from potential authors.
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