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Breast cancer risk following Hodgkin lymphoma radiotherapy in relation to menstrual and reproductive factors

Lookup NU author(s): Dr Helen Lucraft


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Background: Women treated with supradiaphragmatic radiotherapy (sRT) for Hodgkin lymphoma (HL) at young ages have a substantially increased breast cancer risk. Little is known about how menarcheal and reproductive factors modify this risk.Methods: We examined the effects of menarcheal age, pregnancy, and menopausal age on breast cancer risk following sRT in case-control data from questionnaires completed by 2497 women from a cohort of 5002 treated with sRT for HL at ages <36 during 1956-2003.Results: Two-hundred and sixty women had been diagnosed with breast cancer. Breast cancer risk was significantly increased in patients treated within 6 months of menarche (odds ratio (OR) 5.52, 95% confidence interval (CI) (1.97-15.46)), and increased significantly with proximity of sRT to menarche (P-trend<0.001). It was greatest when sRT was close to a late menarche, but based on small numbers and needing reexamination elsewhere. Risk was not significantly affected by full-term pregnancies before or after treatment. Risk was significantly reduced by early menopause (OR 0.55, 95% CI (0.35-0.85)), and increased with number of premenopausal years after treatment (P-trend = 0.003).Conclusion: In summary, this paper shows for the first time that sRT close to menarche substantially increases breast cancer risk. Careful consideration should be given to follow-up of these women, and to measures that might reduce their future breast cancer risk.

Publication metadata

Author(s): Cooke R, Jones ME, Cunningham D, Falk SJ, Gilson D, Hancock BW, Harris SJ, Horwich A, Hoskin PJ, Illidge T, Linch DC, Lister TA, Lucraft HH, Radford JA, Stevens AM, Syndikus I, Williams MV, Swerdlow AJ, England Wales Hodgkin Lymphoma

Publication type: Article

Publication status: Published

Journal: British Journal of Cancer

Year: 2013

Volume: 108

Issue: 11

Pages: 2399-2406

Print publication date: 01/06/2013

Online publication date: 07/05/2013

ISSN (print): 0007-0920

Publisher: Nature Publishing Group


DOI: 10.1038/bjc.2013.219


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