Infiltrating ductal breast carcinoma after radiotherapy and chemotherapy for non-Hodgkin's lymphoma in a young woman. Case report

Lymphoma was one of the first cancers curable by radiotherapy and/or chemotherapy. However the increased risk of second malignancies in lymphoma survivors appeared to be the price of success of modern treatment modalities. In particular, breast cancer has been a major concern among women irradiated for lymphoma at a young age. There are several reports of breast cancer after Hodgkin's lymphoma, but few after non-Hodgkin's lymphoma. Owing to the particularity of this condition and the difficulties in its diagnosis and treatment, we wish to report the case of ductal infiltrant carcinoma of the breast in a young woman survived to a non-Hodgkin's lymphoma. Women who are survivors of pediatric lymphoma have a significantly increased risk of subsequent breast cancer compared with the general population and are at a high risk of developing bilateral disease within a short interval. Several studies have shown that the relative risk for secondary breast cancer becomes significantly increased between 5 and 9 years and rises dramatically between 15 and 19 years after lymphoma treatment. Screening programs to detect breast cancer should be initiated early after Hodgkin's and non-Hodgkin's lymphomas. Screening have to include breast self examinations every month, clinical breast examinations every 6 months, and mammography every 2-3 years. The patients should start breast self-examination at puberty. In these high-risk patients, "aggressive" biopsy is appropriate for suspicious lesions.