A Case Report on Breast Cancer Following Mantle Radiation for Hodgkin Lymphoma - Screening and Management

Sep 21, 2026

Uploaded by Maeve

Hodgkin lymphoma survivors who received mantle radiation face increased risk of secondary malignant neoplasms, yet no standardized screening guideline exists for this group. The case describes a patient with prior Hodgkin lymphoma treated with mantle field radiation, subsequent thyroid cancer managed by thyroidectomy, and later breast cancer. Mantle radiation risks include secondary thyroid, breast, lung, and cardiovascular disease. Technology-driven treatment changes persist, but optimal breast screening intervals and modalities remain uncertain, supporting personalized screening strategies.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Introduction

Case Presentation

How to cite this article

Open Access Case Report DOI: 10.7759/cureus.62584 Review began 05/07/2024 Review ended 06/13/2024 Published 06/18/2024 © Copyright 2024 Mansour et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. A Case Report on Breast Cancer Following Mantle Radiation for Hodgkin Lymphoma: Screening and Management Yasmeen Mansour 1, Akintunde Akinleye 2 1. Medicine, Sovah Health, Danville, USA 2. Sovah Cancer Center, Sovah Health, Danville, USA Corresponding author: Yasmeen Mansour, [dr.yasmeenmansour@gmail.com](dr.yasmeenmansour@gmail.com) Abstract Hodgkin lymphoma survivors who received mantle radiation are at risk of developing secondary malignant neoplasms. There is no established recommended screening guideline for this population. We discuss the case of a patient with a history of Hodgkin lymphoma status post-mantle field radiation, thyroid cancer status post-thyroidectomy, and now breast cancer following mantle radiation. The risk of adverse effects from mantle field radiation is well documented and includes secondary cancers of the thyroid, breast, lung, and cardiovascular disease. Advances in technology have led to an international paradigm shift in the management of Hodgkin lymphoma to reduce the diameter and dose of radiation based on the patient’s anatomy. However, there is no consensus regarding the optimal frequency or modality of breast cancer screening in patients with Hodgkin lymphoma status post-mantle radiation who are now in remission. We discuss screening methods for this population, which has a high risk of developing breast cancer, and emphasize the need for personalized medicine. Categories: Internal Medicine, Radiation Oncology, Oncology Keywords: breast cancer screening, screening mammogram, hodgkin lymphoma, hodgkin disease (hd), secondary cancer, screening, breast cancer, mantle radiation, mantle field radiation Introduction Hodgkin lymphoma was treated with mantle field radiation from the 1960s to as recent as the 1990s. Patients who received mantle radiation (radiotherapy to the neck, chest, and axilla) when it was more common and survived could be as young as 25 years of age now and over 70 years of age. The literature has established that this population has an above-average risk for developing secondary cancers, including breast, thyroid, and lung cancers, and cardiovascular disease [1] . The international community is exploring ways to minimize the acute and chronic adverse effects of both radiation and chemotherapy management of Hodgkin lymphoma [2-5]. Modern advances in technology have allowed for a paradigm shift in personalized radiation that minimizes the radiation dose to the surrounding anatomy. As the field of medicine advances toward personalized disease management, it also holds the potential for personalized screening. The American College of Radiology (ACR) recommends that women with a history of mantle radiation, in addition to annual screening mammography, should receive supplemental screening contrast-enhanced breast MRI [6] . While the recommendation for women of average risk is to start screening at the age of 40, women with a history of mantle radiation are considered high risk and should begin screening earlier. By the age of 30, all women should be evaluated for breast cancer risk to stratify those at high risk so that they can start supplemental screening. The medical community has not reached a consensus, however, on the screening frequency and modality of patients who received mantle radiation. Case Presentation An adult female with a past medical history of essential hypertension, hyperlipidemia, depression, Hodgkin disease status post-splenectomy and mantle radiation, in remission, and thyroid cancer status post-total thyroidectomy, in remission,

FAQs

Why are Hodgkin lymphoma survivors who received mantle radiation considered high risk for breast cancer?

Mantle radiation is associated with well-documented late adverse effects, including secondary cancers such as breast cancer, along with thyroid and lung cancers and cardiovascular disease.

What screening approach is recommended for women with a history of mantle radiation?

The American College of Radiology recommends annual screening mammography plus supplemental contrast-enhanced breast MRI, and suggests earlier risk evaluation and stratification for high-risk patients.

What diagnostic findings were reported in the case presentation?

Mammography and ultrasound identified bilateral breast lesions with BI-RADS 5, leading to recommended biopsy. The biopsies showed high-grade invasive ductal carcinoma patterns, with differing receptor profiles between the right and left breast lesions.

Sep 21, 2026

Uploaded by Maeve