LUMPECTOMY AND BREAST IRRADIATION FOR BREAST-CANCER AFTER RADIOTHERAPY FOR LYMPHOMA

Six women received irradiation for lymphoma (Hodgkin's disease, n = 5; non-Hodgkin's disease, n = 1) to at least a mediastinal field (n = 2) or to a mantle field (n = 4), and subsequently developed breast cance r 10-27 years later. Three patients also received chemotherapy as a co mponent of therapy for lymphoma. For breast cancer, all were treated w ith lumpectomy and breast irradiation to 5,000 cGy in 25 fractions plu s a 1,000 cGy/5 fraction boost to the operative area using electrons. Two patients received adjuvant chemotherapy and three others tamoxifen for breast cancer. All women are alive and free of disease 15-118 mon ths (median, 60 months) following breast irradiation. There have been no cases of significant acute reactions and no late sequelae such as s kin pigmentation changes, subcutaneous fibrosis, rib fractures, cardia c disease, or pulmonary fibrosis. The cosmetic result is considered go od or excellent in all. Lumpectomy and breast irradiation is not contr aindicated in the woman who develops breast cancer many years after ir radiation of lymph node regions above the diaphragm for lymphoma.