Clinical Scorecard: Incidence of Non-Hodgkin Lymphoma Among Survivors of Breast Cancer: A Nationwide Cohort Analysis
At a Glance
Category
Detail
Condition
Non-Hodgkin lymphoma (NHL) incidence among breast cancer survivors
Key Mechanisms
Heterogeneous NHL subtypes with variable clinical behaviors; potential influence of immune suppression and hormonal factors; breast cancer treatments including surgery, chemotherapy, radiation, and hormone therapy
Target Population
Korean women aged ≥20 years with incident breast cancer undergoing curative treatment
Care Setting
National health insurance system with population-based registry data
Key Highlights
NHL is the most common hematologic malignancy with variable 5-year survival rates depending on stage and subtype.
Breast cancer survivors have an increased risk of developing NHL compared to the general population.
Previous studies on NHL risk in breast cancer patients lacked detailed treatment and lifestyle data; this study uses comprehensive national registry data.
Guideline-Based Recommendations
Diagnosis
Confirm breast cancer diagnosis using ICD-10 code C50 with ≥3 claims within 1 year or inpatient hospitalization claim.
Confirm NHL diagnosis using ICD-10 codes C82–C85 or C96 with ≥3 claims within 1 year or inpatient claim.
Classify NHL subtypes based on ICD-10 codes: DLBCL (C83.3), follicular lymphoma (C82), mature T/NK-cell lymphomas (C84), ALCL (C84.6, C84.7), others (C96).
Management
Classify breast cancer treatment within 1 year of diagnosis: surgery only or surgery plus chemotherapy, radiation, or hormone therapy.
Consider hormone receptor status in breast cancer treatment selection due to potential influence on NHL risk.
Monitoring & Follow-up
Monitor breast cancer survivors longitudinally for development of NHL using national health insurance claims data.
Include health screening examinations as baseline for risk assessment.
Risks
Increased NHL risk observed in breast cancer survivors compared to matched controls.
Potential influence of hormone therapy and menopausal status on NHL incidence requires further evaluation.
Patient & Prescribing Data
Breast cancer survivors receiving curative treatment in Korea
Treatment data include surgery, chemotherapy, radiation, and hormone therapy claims within 1 year of breast cancer diagnosis; detailed treatment exposure is essential for assessing NHL risk.
Clinical Best Practices
Use comprehensive national registry data to identify incident breast cancer and subsequent NHL cases accurately.
Incorporate detailed treatment and health screening data to evaluate second malignancy risks.
Recognize the heterogeneity of NHL subtypes when assessing risk and outcomes in breast cancer survivors.
by Danbee Kang, Sang Eun Yoon, Dongwook Shin, Jin Lee, Yun Soo Hong, Se Kyung Lee, Jeong Eon Lee, Yeon Hee Park, Jin Seok Ahn, Eliseo Guallar, Won Seog Kim, Jungho Lee, Seok Jin Kim, Juhee Cho
The research findings of experts from Roswell Park Comprehensive Cancer Center will be featured during the American Society of Clinical Oncology (ASCO) annual meeting May 29 to June 2 at McCormick Place in Chicago
Join our experts for a panel discussion on Breast Cancer & Gynecologic Cancer, originally webcast October 21, 2021.
Topics included everything from breast cancer prevention, to state-of-the-art holistic treatments, and advances in gynecologic cancer care, including robotics and therapeutics.
