Landmark study describes long-term risk of breast cancer from lymphoma treatment
Monday 25 June 2012
Scientists have revealed that women who have been treated for Hodgkin lymphoma at young ages have up to a 50 per cent chance of developing breast cancer over the 40 years after treatment. The study, the world’s largest of its kind, will give this patient group a highly individualised assessment of their risk for the first time. The paper is published online today in the Journal of Clinical Oncology.
The Breakthrough Breast Cancer funded study, conducted by scientists at The Institute of Cancer Research (ICR), in collaboration with doctors from hospitals across England and Wales, looked at 5,000 British women over a 50 year period. They found a fivefold increased risk of breast cancer for young women who received radiotherapy to their chest as a treatment for Hodgkin lymphoma. The highest risks found in this group were comparable to those in women who have a faulty BRCA gene.
Although it was known that these patients had an increased breast cancer risk, this new research shows specifically what this risk is, depending on the age a woman receives her treatment, the type of treatment she received and how long it is since she was treated. The study showed that women who had radiotherapy treatment to their chest at ages 10-14 were at the highest risk of developing the disease. Their risk was 22 times higher than that in the general population of the same age. Risks remained raised for at least 40 years, with women continuing to have raised risks of developing breast cancer when in their 50s and 60s.
This research has important implications for this patient group. The new data mean that doctors can confidently give advice on a patient’s chance of getting breast cancer and therefore make them aware of possible preventative measures.
Senior author Professor Anthony Swerdlow from The Institute of Cancer Research said: “By following such a large group of women over such a long time period, we have created the most detailed picture yet of the risk that these women face. Importantly, our study enables this group of women to receive clear information about their personal breast cancer risk, to help their doctors and them to make decisions about preventive measures. It takes us a step closer to more-personalised medical plans.”
The paper also suggests tangible actions for how the results can make a difference to patients. A protocol for breast screening already exists in the UK for these women. However, these data provide additional information regarding the levels of risk and will help to refine future screening strategies.
Dr Sacha Howell, a medical oncologist at the University of Manchester and The Christie Hospital, wants to use Professor Swerdlow’s research in this way.
“This research is hugely important for a group of women that are at very high risk of developing breast cancer. These results will help us to advise these women about their particular risk and ensure that the most appropriate screening is performed on a regular basis,” Dr Howell said.
All of the women studied had received radiotherapy to treat Hodgkin lymphoma under of the age 36 and were identified as part of a Department of Health initiative launched in November 2003 to identify, inform and initiate breast screening in such women. Several hundred young women are diagnosed with Hodgkin lymphoma every year, and for this group, findings like this are crucial. The risk is not substantially raised, however, in women treated for Hodgkin Lymphoma with radiotherapy over the age of 40.
Dr Julia Wilson, Head of Research at Breakthrough Breast Cancer, said: “Studies like this are fundamental to improving our understanding of rarer breast cancer groups. The rich data studied from patients across England and Wales, coupled with the clear and actionable results, means that a big difference can be made for these at risk women.”
Notes to Editors
About breast cancer:
- Breast cancer is the most commonly diagnosed cancer in the UK – nearly 48,000 women and around 300 men are diagnosed every year.
- Breast cancer accounts for nearly 1 in 3 of all female cancers and one in eight women in the UK will develop breast cancer at some point in their lifetime.
- Around 1,000 women die of breast cancer every month in the UK.
- The good news is that more women than ever in the UK are surviving breast cancer thanks to better awareness, better treatments and better screening.
Breakthrough Breast Cancer
- Breakthrough Breast Cancer is dedicated to improving and saving lives through finding the causes of breast cancer, enabling early detection, ensuring precise diagnosis, discovering new and better treatments and improving medical services.
- Breakthrough Breast Cancer funds ground-breaking research, campaign for better services and treatments and raise awareness of the signs and symptoms of breast cancer. Through this work the charity believes passionately that breast cancer can be beaten and the fear of the disease removed for good. Find more information at www.breakthrough.org.uk
The Institute of Cancer Research (ICR) is one of the world’s most influential cancer research institutes.
Scientists and clinicians at the ICR are working every day to make a real impact on cancer patients’ lives. Through its unique partnership with The Royal Marsden Hospital and ‘bench-to-bedside’ approach, the ICR is able to create and deliver results in a way that other institutions cannot. Together the two organisations are rated in the top four cancer centres globally.
The ICR has an outstanding record of achievement dating back more than 100 years. It provided the first convincing evidence that DNA damage is the basic cause of cancer, laying the foundation for the now universally accepted idea that cancer is a genetic disease. Today it leads the world at isolating cancer-related genes and discovering new targeted drugs for personalised cancer treatment.
As a college of the University of London, the ICR provides postgraduate higher education of international distinction. It has charitable status and relies on support from partner organisations, charities and the general public.
The ICR’s mission is to make the discoveries that defeat cancer. For more information visit www.icr.ac.uk.