Multicenter study of association between doxorubicin exposure and breast cancer risk in survivors of adolescent and adult Hodgkin lymphoma

A retrospective study at 20 hospitals in The Netherlands evaluated whether doxorubicin exposure is associated with breast cancer (BC) risk in female 5-year Hodgkin lymphoma (HL) survivors treated at age 15-50 years, between 1975 and 2008. The study found that almost one in five survivors developed BC during 30 years of follow-up. Exposure to a cumulative doxorubicin dose of > 200 mg/m² was associated with a 1.5-fold increased BC risk, independent of age at HL treatment, receipt of chest radiotherapy, or gonadotoxic therapy. Despite lower doses and smaller volumes of radiotherapy in contemporary treatment regimes, BC risk has not decreased in survivors treated between 1998 and 2008 compared with survivors treated between 1975 and 1986 (dotted lines show the BC risk in the Dutch general population). The authors conclude that treatment with doxorubicin is associated with increased BC risk in survivors of adolescent and adult HL.