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Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging
BACKGROUND: Female survivors of pediatric Hodgkin lymphoma (HL) who have received chest radiotherapy are at increased risk of breast cancer. Guidelines for early breast cancer screening among these survivors are based on little data regarding clinical outcomes. This study reports outcomes of breast...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BlackWell Publishing Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283737/ https://www.ncbi.nlm.nih.gov/pubmed/24888639 http://dx.doi.org/10.1002/cncr.28747 |
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author | Tieu, Minh Thi Cigsar, Candemir Ahmed, Sameera Ng, Andrea Diller, Lisa Millar, B-A Crystal, Pavel Hodgson, David C |
author_facet | Tieu, Minh Thi Cigsar, Candemir Ahmed, Sameera Ng, Andrea Diller, Lisa Millar, B-A Crystal, Pavel Hodgson, David C |
author_sort | Tieu, Minh Thi |
collection | PubMed |
description | BACKGROUND: Female survivors of pediatric Hodgkin lymphoma (HL) who have received chest radiotherapy are at increased risk of breast cancer. Guidelines for early breast cancer screening among these survivors are based on little data regarding clinical outcomes. This study reports outcomes of breast cancer screening with MRI and mammography (MMG) after childhood HL. METHODS: We evaluated the results of breast MRI and MMG screening among 96 female survivors of childhood HL treated with chest radiotherapy. Outcomes measured included imaging sensitivity and specificity, breast cancer characteristics, and incidence of additional imaging and breast biopsy. RESULTS: Median age at first screening was 30 years, and the median number of MRI screening rounds was 3. Ten breast cancers were detected in 9 women at a median age of 39 years (range, 24-43 years). Half were invasive and half were preinvasive. The median size of invasive tumors was 8 mm (range, 3-15 mm), and none had lymph node involvement. Sensitivity and specificity of the screening modalities were as follows: for MRI alone, 80% and 93.5%, respectively; MMG alone, 70% and 95%, respectively; both modalities combined, 100% and 88.6%, respectively. All invasive tumors were detected by MRI. Additional investigations were required in 52 patients, (54%), and 26 patients (27%) required breast biopsy, with 10 patients requiring more than 1 biopsy. CONCLUSIONS: Screening including breast MRI with MMG has high sensitivity and specificity in pediatric HL survivors, with breast cancers detected at an early stage, although it is associated with a substantial rate of additional investigations. Cancer 2014;120:2507–2513. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Screening female survivors of pediatric Hodgkin Lymphoma for breast cancer with MRI and mammography detected tumors at an earlier stage than prior studies of mammography alone, although a substantial proportion of women required additional tests for benign imaging findings. The 5-year cumulative incidence of invasive or preinvasive tumors after initiating screening was 10.8%. |
format | Online Article Text |
id | pubmed-4283737 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BlackWell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-42837372015-01-14 Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging Tieu, Minh Thi Cigsar, Candemir Ahmed, Sameera Ng, Andrea Diller, Lisa Millar, B-A Crystal, Pavel Hodgson, David C Cancer Original Articles BACKGROUND: Female survivors of pediatric Hodgkin lymphoma (HL) who have received chest radiotherapy are at increased risk of breast cancer. Guidelines for early breast cancer screening among these survivors are based on little data regarding clinical outcomes. This study reports outcomes of breast cancer screening with MRI and mammography (MMG) after childhood HL. METHODS: We evaluated the results of breast MRI and MMG screening among 96 female survivors of childhood HL treated with chest radiotherapy. Outcomes measured included imaging sensitivity and specificity, breast cancer characteristics, and incidence of additional imaging and breast biopsy. RESULTS: Median age at first screening was 30 years, and the median number of MRI screening rounds was 3. Ten breast cancers were detected in 9 women at a median age of 39 years (range, 24-43 years). Half were invasive and half were preinvasive. The median size of invasive tumors was 8 mm (range, 3-15 mm), and none had lymph node involvement. Sensitivity and specificity of the screening modalities were as follows: for MRI alone, 80% and 93.5%, respectively; MMG alone, 70% and 95%, respectively; both modalities combined, 100% and 88.6%, respectively. All invasive tumors were detected by MRI. Additional investigations were required in 52 patients, (54%), and 26 patients (27%) required breast biopsy, with 10 patients requiring more than 1 biopsy. CONCLUSIONS: Screening including breast MRI with MMG has high sensitivity and specificity in pediatric HL survivors, with breast cancers detected at an early stage, although it is associated with a substantial rate of additional investigations. Cancer 2014;120:2507–2513. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Screening female survivors of pediatric Hodgkin Lymphoma for breast cancer with MRI and mammography detected tumors at an earlier stage than prior studies of mammography alone, although a substantial proportion of women required additional tests for benign imaging findings. The 5-year cumulative incidence of invasive or preinvasive tumors after initiating screening was 10.8%. BlackWell Publishing Ltd 2014-08-15 2014-05-28 /pmc/articles/PMC4283737/ /pubmed/24888639 http://dx.doi.org/10.1002/cncr.28747 Text en © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society http://creativecommons.org/licenses/by-nc/3.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Tieu, Minh Thi Cigsar, Candemir Ahmed, Sameera Ng, Andrea Diller, Lisa Millar, B-A Crystal, Pavel Hodgson, David C Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging |
title | Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging |
title_full | Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging |
title_fullStr | Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging |
title_full_unstemmed | Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging |
title_short | Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging |
title_sort | breast cancer detection among young survivors of pediatric hodgkin lymphoma with screening magnetic resonance imaging |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283737/ https://www.ncbi.nlm.nih.gov/pubmed/24888639 http://dx.doi.org/10.1002/cncr.28747 |
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