{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:44:03Z","timestamp":1791924243509,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T00:00:00Z","timestamp":1666656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004622","name":"KWF Kankerbestrijding","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,12,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Hodgkin lymphoma (HL) survivors treated with chest radiotherapy have an increased risk of breast cancer (BC). Prior HL treatment and associated cardiovascular disease (CVD) risk may limit BC treatment options. It is unknown how treatment adaptations affect BC and CVD outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors compared 195\u2009BC patients treated with chest\/axillary radiotherapy for HL (BC\u2010HL) with 5988 age\u2010 and calendar year\u2010matched patients with first primary BC (BC\u20101). Analyses included cumulative incidence functions and Cox regression models, accounting for tumor characteristics and BC treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to BC\u20101 patients, BC\u2010HL patients received anthracycline\u2010containing chemotherapy (23.7% vs. 43.8%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and breast\u2010conserving surgery followed by radiotherapy (7.1% vs. 57.7%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) less often. BC treatment considerations were reported for 71% of BC\u2010HL patients. BC\u2010HL patients had a significantly higher risk of 15\u2010year overall mortality than BC\u20101 patients (61% vs. 23%). Furthermore, risks of BC\u2010specific mortality and nonfatal BC events were significantly increased among BC\u2010HL patients, also when accounting for tumor and treatment characteristics (2.2\u2010 to 4.5\u2010fold). BC\u2010HL patients with a screen\u2010detected BC had a significantly reduced (61%) BC\u2010specific mortality. One\u2010third of BC\u2010HL patients had CVD at BC\u2010diagnosis, compared to &lt;0.1% of BC\u20101 patients. Fifteen\u2010year CVD\u2010specific mortality and CVD incidence were significantly higher in BC\u2010HL patients than in BC\u20101 patients (15.2% vs. 0.4% and 40.4% vs. 6.8%, respectively), which was due to HL treatment rather than BC treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BC\u2010HL patients experience a higher burden of CVD and worse BC outcomes than BC\u20101 patients. Clinicians should be aware of increased CVD risk when selecting BC treatment for HL survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Lay summary<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Patients with breast cancer after Hodgkin lymphoma (BC\u2010HL) may have limited options for BC treatment, due to earlier HL treatment and an associated increased risk of cardiovascular disease (CVD).<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>BC treatment considerations were reported for 71% of BC\u2010HL patients.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>We examined whether BC\u2010HL patients have a higher risk of CVD or BC events (recurrences\/metastases) compared to patients with breast cancer that had no earlier tumors (BC\u20101).<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>We observed a higher burden of CVD and worse BC outcomes in HL patients compared to BC\u20101 patients.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Clinicians should be aware of increased CVD risk when selecting BC treatment for HL survivors.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34464","type":"journal-article","created":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T04:19:29Z","timestamp":1666671569000},"page":"4285-4295","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Breast cancer and cardiovascular outcomes after breast cancer in survivors of Hodgkin lymphoma"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2378-5424","authenticated-orcid":false,"given":"Inge M.","family":"Krul","sequence":"first","affiliation":[{"name":"Department of Epidemiology The Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi B.","family":"Boekel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology The Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology The Netherlands Cancer Institute  Amsterdam The Netherlands"},{"name":"Division of Molecular Pathology The Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile P. M.","family":"Janus","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Erasmus University MC Cancer Institute  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustinus D. G.","family":"Krol","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marten R.","family":"Nijziel","sequence":"additional","affiliation":[{"name":"Department of Hematology Catharina Hospital  Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9e M.","family":"Zijlstra","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC, Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard W. M.","family":"van der Maazen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith M.","family":"Roesink","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9214-5263","authenticated-orcid":false,"given":"Judy N.","family":"Jacobse","sequence":"additional","affiliation":[{"name":"Department of Epidemiology The Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schaapveld","sequence":"additional","affiliation":[{"name":"Department of Epidemiology The Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjanka K.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology The Netherlands Cancer Institute  Amsterdam The Netherlands"},{"name":"Division of Molecular Pathology The Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemieke W. 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