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Current overview and special considerations for second breast cancer in Hodgkin lymphoma survivors

Journal

CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
Volume 157, Issue -, Pages -

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.critrevonc.2020.103175

Keywords

Hodgkin lymphoma; Breast cancer; Second cancer; Radiation therapy; Childhood; Malignancy; Young adulthood malignancy; Cancer survivorship

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Second breast cancer is the most common solid cancer among female survivors of Hodgkin Lymphoma, with risk factors including age at treatment, dose of radiation, and extent of irradiated field. These cancers tend to develop at a younger age, are often bilateral, and have aggressive biological features and poor prognosis. While literature does not firmly answer the benefits of breast surveillance, evidence leans towards clinical benefits of early detection.
Second breast cancer (SBC) is the most common solid cancer among Hodgkin Lymphoma (HL) female survivors. We reviewed the related modifying risk factors, radiation-induced carcinogenesis, tumors characteristics, management specificities, prevention and surveillance modalities based on current evidence. The risk of developing SBC may be influenced essentially by the age at HL treatment, follow-up latency, dose of irradiation received and the extent of irradiated field. SBCs generally develop at younger age, they are often bilateral, and exhibit more aggressive biological features and worse prognosis. No firm answer about the benefits of breast surveillance is provided by literature, but compelling evidence tends toward a clinical benefit in early detection. Increasing awareness among health providers' care and current survivors as well as the implementation of screening measures is crucial. Great efforts are ongoing in individualizing treatment strategies for future HL patients and response-adapted approaches are holding promise in prevention of these second malignancies.

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