MRI Finds Breast Cancer Early in Survivors of Childhood Hodgkin Lymphoma

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Women who had radiation to the chest as children to treat a cancer other than breast cancer, such as Hodgkin lymphoma (cancer of the immune system), have a higher risk of breast cancer.

A study has found that MRI (magnetic resonance imaging) can detect breast cancer in survivors of childhood Hodgkin lymphoma early, when it’s most treatable.

The research was published online on May 28, 2014 by the journal Cancer. Read “Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging.”

In recent decades, some of the most important medical discoveries have been in treating childhood cancer. Still, some childhood cancer patients develop a second cancer or another serious medical condition later in life that's believed to be related to treatment for the childhood cancer. Doctors don’t completely understand why childhood cancer survivors are more likely to be diagnosed with a different cancer later in life. For some, it could be genetics that make them more likely to develop cancer. For others, the higher cancer risk is probably related to the childhood cancer treatment. For example, radiation used to treat childhood cancer also can affect normal cells that are exposed to the radiation, causing a new, different cancer -- such as breast cancer -- to develop decades later.

From 2005 to 2013, the researchers for this study used breast MRI and digital mammography to screen 96 women who were survivors of childhood Hodgkin lymphoma that was treated with chest radiation. Overall, 274 breast MRIs were done. Half the women were younger than 30 years old when they had their first MRI screening and half were older. The women had about three MRI screenings and three mammogram screenings each.

During the study, 10 breast cancers were found in nine women who were 24 to 43 years old:

  • five of the cancers were invasive, meaning they had grown into normal, healthy tissue
  • the other five were non-invasive, meaning they were confined to the milk ducts or lobules in the breast (these types of cancers are also called carcinoma in situ or pre-cancers)
  • the cancers ranged in size from 3 mm to 15 mm
  • none of the cancers had spread to the lymph nodes

Of the 10 cancers found:

  • five were detected by both MRI and mammogram
  • three were detected only by MRI
  • two were detected only by mammogram, but these two cancers were non-invasive

In earlier studies that used only mammography to screen for breast cancer in survivors of childhood Hodgkin lymphoma, half of the cancers detected had already spread to the lymph nodes.

It’s important to know that about half of the women had what’s called a false positive MRI result. This is when the MRI finds an area that looks like cancer but turns out to be normal. Besides worrying about being diagnosed with breast cancer, a false positive means more tests and follow-up visits, which can be stressful and scary. Still, other research has found that while false positive results do cause anxiety and stress, the anxiety is short-term and doesn’t affect a woman’s overall health and well-being.

This study suggests that childhood cancer survivors need a screening plan that’s tailored to their unique needs and risks.

Other research has shown that childhood cancer survivors are at much higher risk for a number of health problems in adulthood, including cancer. Because of these risks, people who have been treated for childhood cancer should take aggressive steps to minimize their risk of another cancer. These people also should have regular screenings for any complications of earlier treatment, including heart and lung disease as well as cancer.

If you've been treated in the past for cancer, it's important to regularly see a doctor who:

  • is familiar with your past medical history
  • understands your special risks
  • can give you the necessary counseling, monitoring, and screening for possible complications of your earlier treatment

If your childhood cancer treatment included radiation therapy to the chest area, your risk of breast cancer is most likely higher than average. You and your doctor should consider a more aggressive breast cancer screening plan. This plan might include more frequent mammograms starting at an earlier age and possibly using different screening techniques, such as breast MRI.

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