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Blood, 15 November 2005, Vol. 106, No. 10, pp. 3358-3365.
Prepublished online as a Blood First Edition Paper on July 28, 2005; DOI 10.1182/blood-2005-04-1535.


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CLINICAL TRIALS AND OBSERVATIONS

Breast cancer risk following radiotherapy for Hodgkin lymphoma: modification by other risk factors

Deirdre A. Hill, Ethel Gilbert, Graça M. Dores, Mary Gospodarowicz, Flora E. van Leeuwen, Eric Holowaty, Bengt Glimelius, Michael Andersson, Tom Wiklund, Charles F. Lynch, Mars van't Veer, Hans Storm, Eero Pukkala, Marilyn Stovall, Rochelle E. Curtis, James M. Allan, John D. Boice, and Lois B. Travis

From the Division of Cancer Epidemiology and Genetics and Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD; Princess Margaret Hospital, University of Toronto, ON, Canada; Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Care Ontario, Toronto, ON, Canada; Uppsala University, Sweden; Danish Cancer Society, Copenhagen, Denmark; Helsinki University Central Hospital, Finland; University of Iowa, Iowa City; Finnish Cancer Registry, Helsinki, Finland; The Dr Daniel Den Hoed Cancer Center, Rotterdam, the Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Epidemiology and Genetics Unit, University of York, United Kingdom; International Epidemiology Institute, Rockville, MD; and Vanderbilt University Medical Center, Nashville, TN.

The importance of genetic and other risk factors in the development of breast cancer after radiotherapy (RT) for Hodgkin lymphoma (HL) has not been determined. We analyzed data from a breast cancer case-control study (105 patients, 266 control subjects) conducted among 3 817 survivors of HL diagnosed at age 30 years or younger in 6 population-based cancer registries. Odds ratios (ORs) and excess relative risks (ERRs) were calculated using conditional regression. Women who received RT exposure (≥ 5 Gy radiation dose to the breast) had a 2.7-fold increased breast cancer risk (95% confidence interval (CI) 1.4-5.2), compared with those given less than 5 Gy. RT exposure (≥ 5 Gy) was associated with an OR of 0.8 (95% CI, 0.2-3.4) among women with a first- or second-degree family history of breast or ovarian cancer, and 5.8 (95% CI, 2.1-16.3) among all other women (interaction P = .03). History of a live birth appeared to increase the breast cancer risk associated with RT among women not treated with ovarian-damaging therapies. Breast cancer risk following RT varied little according to other factors. The additional increased relative risk of breast cancer after RT for HL is unlikely to be larger among women with a family history of breast or ovarian cancer than among other women.


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