Advertisement

Breast cancer in adolescents and young women

      Abstract

      Breast cancer is very rare in adolescents and very young women. Less than 1% of all breast cancer cases occur before the age of 30 years (Natl Cancer Inst Monogr 16 (1994) 69). Invasive breast cancer occurring in women before the age of 35 years has a more aggressive biological behaviour and is associated with a worse prognosis than in older premenopausal women. Breast cancers in these young women are more frequently poorly differentiated, oestrogen-receptor (ER)-negative, have lymphovascular invasion and high proliferating fractions. Breast-conserving surgery in women <35 years old is associated with a higher risk of local recurrence than in older women. All young women should be considered at moderate-high risk by virtue of their age alone and offered adjuvant therapy. The long-term toxicity of adjuvant therapies is a particular concern when treating these women. The implications of possible fertility impairment and premature menopause require consideration when discussing adjuvant chemotherapy and endocrine therapy. Adolescents and young women are particularly vulnerable to emotional distress and psychosocial problems and should be provided with appropriate support. Young women who are at a potential high-risk of developing breast cancer such as those with germline mutations of BRCA1, BRCA2, TP53, PTEN or who have previously received mantle irradiation for Hodgkin's disease need close follow-up and are candidates for screening from a young age.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Cancer
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Surveillance E, and End Results (SEER) Program Public-Use CD-ROM (1973–1997). National Cancer Institute, DCCPS, Cancer Surveillance Research Program, Cancer Statistics Branch, released April 2000, based on August 1999 submission. In; 2000.

        • Bothroyd A.C.H.
        Breast masses in childhood and adolescence.
        Pediatr. Radiol. 1994; 24: 81-85
        • Ferguson T.B.M.K.
        • Filston H.C.
        Juvenile secretory carcinoma and juvenile papillomatosis.
        J. Pediatr. Surg. 1987; 22: 637-639
        • Karl S.R.B.T.
        • Zaino R.
        Juvenile secretory carcinoma of the breast.
        J. Pediatr. Surg. 1985; 20: 368-371
        • Swanson G.M.
        • Lin C.S.
        Survival patterns among younger women with breast cancer.
        J. Natl. Cancer Inst. Monogr. 1994; 16: 69-77
        • Rosen P.P.C.M.
        Secretory carcinoma of the breast.
        Arch Pathol. Lab. Med. 1991; 115: 141-144
        • Serour F.G.A.
        • Kopolovic J.
        • et al.
        Secretory breast cancer in childhood and adolescence.
        Med. Pediatr. Oncol. 1992; 20: 341-344
        • Aebi S.
        • Gelber S.
        • Castiglione-Gertsch M.
        • et al.
        Is chemotherapy alone adequate for young women with oestrogen-receptor-positive breast cancer?.
        Lancet. 2000; 355: 1869-1874
        • Walker R.A.
        • Lees E.
        • Webb M.B.
        • Dearing S.J.
        Breast carcinomas occurring in young women (<35 years) are different.
        Br. J. Cancer. 1996; 74: 1796-1800
        • Winchester D.P.
        • Osteen R.T.
        • Menck H.R.
        The National Cancer Data Base report on breast carcinoma characteristics and outcome in relation to age.
        Cancer. 1996; 78: 1838-1843
        • Kollias J.E.C.
        • Ellis I.O.
        • Robertson J.F.
        • Blamey R.W.
        Early-onset breast cancer.
        Br. J. Cancer. 1997; 75: 1318-1323
        • Chung M.
        • Chang H.R.
        • Bland K.I.
        • Wanebo H.J.
        Younger women with breast carcinoma have a poorer prognosis than older women.
        Cancer. 1996; 77: 97-103
        • Adami H.O.
        • Malker B.
        • Holmberg L.
        • Persson I.
        • Stone B.
        The relation between survival and age at diagnosis in breast cancer.
        N. Engl. J. Med. 1986; 315: 559-563
        • Albain K.S.
        • Allred D.C.
        • Clark G.M.
        Breast cancer outcome and predictors of outcome.
        J. Natl. Cancer Inst. Monogr. 1994; 16: 35-42
        • Holli K.I.J.
        Effect of age on the survival of breast cancer patients.
        Eur. J. Cancer. 1997; 33: 425-428
        • Kroman N.
        • Jensen M.B.
        • Wohlfahrt J.
        • Mouridsen H.T.
        • Andersen P.K.
        • Melbye M.
        Factors influencing the effect of age on prognosis in breast cancer.
        Br. Med. J. 2000; 320: 474-478
        • Host H.L.E.
        Age as a prognostic factor in breast cancer.
        Cancer. 1986; 57: 2217-2221
        • De La Rochefordiere A.A.B.
        • Campana F.
        • Scholl S.M.
        • et al.
        Age as prognostic factor in premenopausal breast carcinoma.
        Lancet. 1993; 341: 1039-1043
        • Nixon A.J.
        • Neuberg D.
        • Hayes D.F.
        • et al.
        Relationship of patient age to pathologic features of the tumor and prognosis for patients with stage I or II breast cancer.
        J. Clin. Oncol. 1994; 12: 888-894
        • Goldhirsch A.
        • Glick J.H.
        • Gelber R.D.
        • Coates A.S.
        • Senn H.J.
        Meeting highlights.
        J. Clin. Oncol. 2001; 19: 3817-3827
        • Panel NIoHCD
        National Institutes of Health Consensus Development Conference Statement.
        J. Natl. Cancer Inst. 2001; 30: 5-15
        • Gajdos C.
        • Tartter P.I.
        • Bleiweiss I.J.
        • Bodian C.
        • Brower S.T.
        Stage 0 to stage III breast cancer in young women.
        J. Am. Coll. Surg. 2000; 190: 523-529
        • Elkhuizen P.H.
        • van de Vijver M.J.
        • Hermans J.
        • Zonderland H.M.
        • van de Velde C.J.
        • Leer J.W.
        Local recurrence after breast-conserving therapy for invasive breast cancer.
        Int. J. Radiat. Oncol. Biol. Phys. 1998; 40: 859-867
        • Haffty B.G.
        • Fischer D.
        • Rose M.
        • Beinfield M.
        • McKhann C.
        Prognostic factors for local recurrence in the conservatively treated breast cancer patient.
        J. Clin. Oncol. 1991; 9: 997-1003
        • Kurtz J.M.
        • Jacquemier J.
        • Amalric R.
        • et al.
        Why are local recurrences after breast-conserving therapy more frequent in younger patients?.
        J. Clin. Oncol. 1990; 8: 591-598
        • Arriagada R.
        • Le M.G.
        • Contesso G.
        • Guinebretiere J.M.
        • Rochard F.
        • Spielmann M.
        Predictive factors for local recurrence in 2006 patients with surgically resected small breast cancer.
        Ann. Oncol. 2002; 13: 1404-1413
        • Voogd A.C.
        • Nielsen M.
        • Peterse J.L.
        • et al.
        Differences in risk factors for local and distant recurrence after breast-conserving therapy or mastectomy for stage I and II breast cancer.
        J. Clin. Oncol. 2001; 19: 1688-1697
        • Schag C.A.
        • Ganz P.A.
        • Polinsky M.L.
        • Fred C.
        • Hirji K.
        • Petersen L.
        Characteristics of women at risk for psychosocial distress in the year after breast cancer.
        J. Clin. Oncol. 1993; 11: 783-793
        • Bloom J.R.
        • Kessler L.
        Risk and timing of counselling and support interventions for younger women with breast cancer.
        J. Natl. Cancer Inst. Monogr. 1994; 16: 199-206
        • Roberts C.S.
        • Cox C.E.
        • Reintgen D.S.
        • Baile W.F.
        • Gibertini M.
        Influence of physician communication on newly diagnosed breast patients’ psychologic adjustment and decision-making.
        Cancer. 1994; 74: 336-341
        • Roberts C.S.
        • Cox C.E.
        • Shannon V.J.
        • Wells N.L.
        A closer look at social support as a moderator of stress in breast cancer.
        Health Soc. Work. 1994; 19: 157-164
        • Neuling S.J.
        • Winefield H.R.
        Social support and recovery after surgery for breast cancer.
        Soc. Sci. Med. 1988; 27: 385-392
        • Ashley S.
        • Royle G.T.
        • Corder A.
        • et al.
        Clinical, radiological and cytological diagnosis of breast cancer in young women.
        Br. J. Surg. 1989; 76: 835-837
        • Brand I.R.
        • Sapherson D.A.
        • Brown T.S.
        Breast imaging in women under 35 with symptomatic breast disease.
        Br. J. Radiol. 1993; 66: 394-397
        • Kothari A.S.
        • Beechey-Newman N.
        • D'Arrigo C.
        • et al.
        Breast carcinoma in women age 25 years or less.
        Cancer. 2002; 94: 606-614
        • Hochman M.G.
        • Orel S.G.
        • Powell C.M.
        • Schnall M.D.
        • Reynolds C.A.
        • White L.N.
        Fibroadenomas.
        Radiology. 1997; 204: 123-129
        • Colleoni M.
        • Rotmensz N.
        • Robertson C.
        • et al.
        Very young women (<35 years) with operable breast cancer.
        Ann. Oncol. 2002; 13: 273-279
        • Dubsky P.C.
        • Gnant M.F.
        • Taucher S.
        • et al.
        Young age as an independent adverse prognostic factor in premenopausal patients with breast cancer.
        Clin. Breast Cancer. 2002; 3: 65-72
        • Xiong Q.
        • Valero V.
        • Kau V.
        • et al.
        Female patients with breast carcinoma age 30 years and younger have a poor prognosis.
        Cancer. 2001; 92: 2523-2528
        • Goldhirsch A.
        • Gelber R.D.
        • Yothers G.
        • et al.
        Adjuvant therapy for very young women with breast cancer.
        J. Natl. Cancer Inst. Monogr. 2001; 30: 44-51
        • Kurtz J.M.
        • Spitalier J.M.
        • Amalric R.
        • et al.
        Mammary recurrences in women younger than forty.
        Int. J. Radiat. Oncol. Biol. Phys. 1988; 15: 271-276
        • Calle R.
        • Vilcoq J.R.
        • Zafrani B.
        • Vielh P.
        • Fourquet A.
        Local control and survival of breast cancer treated by limited surgery followed by irradiation.
        Int. J. Radiat. Oncol. Biol. Phys. 1986; 12: 873-878
        • van Limbergen E.
        • van den Bogaert W.
        • van der Schueren E.
        • Rijnders A.
        Tumor excision and radiotherapy as primary treatment of breast cancer. Analysis of patient and treatment parameters and local control.
        Radiother. Oncol. 1987; 8: 1-9
        • Kini V.R.
        • White J.R.
        • Horwitz E.M.
        • Dmuchowski C.F.
        • Martinez A.A.
        • Vicini F.A.
        Long term results with breast-conserving therapy for patients with early stage breast carcinoma in a community hospital setting.
        Cancer. 1998; 82: 127-133
        • Stotter A.T.
        • McNeese M.D.
        • Ames F.C.
        • Oswald M.J.
        • Ellerbroek N.A.
        Predicting the rate and extent of locoregional failure after breast conservation therapy for early breast cancer.
        Cancer. 1989; 64: 2217-2225
        • Fowble B.L.
        • Schultz D.J.
        • Overmoyer B.
        • et al.
        The influence of young age on outcome in early stage breast cancer.
        Int. J. Radiat. Oncol. Biol. Phys. 1994; 30: 23-33
        • Borger J.
        • Kemperman H.
        • Hart A.
        • Peterse H.
        • van Dongen J.
        • Bartelink H.
        Risk factors in breast-conservation therapy.
        J. Clin. Oncol. 1994; 12: 653-660
        • Voogd A.C.
        • Peterse J.L.
        • Crommelin M.A.
        • et al.
        Histological determinants for different types of local recurrence after breast-conserving therapy of invasive breast cancer. Dutch Study Group on local Recurrence after Breast Conservation (BORST).
        Eur. J. Cancer. 1999; 35: 1828-1837
        • Schnitt S.J.
        • Connolly J.L.
        • Harris J.R.
        • Hellman S.
        • Cohen R.B.
        Pathologic predictors of early local recurrence in Stage I and II breast cancer treated by primary radiation therapy.
        Cancer. 1984; 53: 1049-1057
        • Osteen R.T.
        • Connolly J.L.
        • Recht A.
        • Silver B.
        • Schnitt S.J.
        • Harris J.R.
        Identification of patients at high risk for local recurrence after conservative surgery and radiation therapy for stage I or II breast cancer.
        Arch. Surg. 1987; 122: 1248-1252
        • Veronesi U.
        • Marubini E.
        • Del Vecchio M.
        • et al.
        Local recurrences and distant metastases after conservative breast cancer treatments.
        J. Natl. Cancer Inst. 1995; 87: 19-27
        • Fourquet A.
        • Campana F.
        • Zafrani B.
        • et al.
        Prognostic factors of breast recurrence in the conservative management of early breast cancer.
        Int. J. Radiat. Oncol. Biol. Phys. 1989; 17: 719-725
        • Anscher M.S.
        • Jones P.
        • Prosnitz L.R.
        • et al.
        Local failure and margin status in early-stage breast carcinoma treated with conservation surgery and radiation therapy.
        Ann. Surg. 1993; 218: 22-28
        • Dewar J.A.
        • Arriagada R.
        • Benhamou S.
        • et al.
        Local relapse and contralateral tumor rates in patients with breast cancer treated with conservative surgery and radiotherapy (Institut Gustave Roussy 1970-1982).
        IGR Breast Cancer Group. Cancer. 1995; 76: 2260-2265
        • Schnitt S.J.
        • Abner A.
        • Gelman R.
        • et al.
        The relationship between microscopic margins of resection and the risk of local recurrence in patients with breast cancer treated with breast-conserving surgery and radiation therapy.
        Cancer. 1994; 74: 1746-1751
        • Macmillan R.D.
        • Purushotham A.D.
        • Mallon E.
        • Love J.G.
        • George W.D.
        Tumour bed positivity predicts outcome after breast-conserving surgery.
        Br. J. Surg. 1997; 84: 1559-1562
        • Early Breast Cancer Trialists’ Collaborative Group
        Polychemotherapy for early breast cancer.
        Lancet. 1998; 352: 930-942
        • Early Breast Cancer Trialists’ Collaborative Group
        Tamoxifen for early breast cancer.
        Lancet. 1998; 351: 1451-1467
        • Levine M.N.
        • Bramwell V.H.
        • Pritchard K.I.
        • et al.
        Randomized trial of intensive cyclophosphamide, epirubicin, and fluorouracil chemotherapy compared with cyclophosphamide, methotrexate, and fluorouracil in premenopausal women with node-positive breast cancer. National Cancer Institute of Canada Clinical Trials Group.
        J. Clin. Oncol. 1998; 16: 2651-2658
        • Henderson I.C.
        • Berry D.A.
        • Demetri G.D.
        • et al.
        Improved outcomes from adding sequential Paclitaxel but not from escalating Doxorubicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer.
        J. Clin. Oncol. 2003; 21: 976-983
        • Mamounas E.P.B.J.
        • Lembersky B.C.
        • Fisher B.
        • et al.
        Paclitaxel (T) following doxorubicin/cyclophosphamide (AC) as adjuvant chemotherapy for node-positive breast cancer: results from NSABP B-28.
        Proc. Am. Soc. Clin. Oncol. 2003; 22: 4
        • Nabholtz J.M.P.T.
        • Mackey J.
        • Pawlicki M.
        • et al.
        Phase III trial comparing TAC (docetaxel, doxorubicin, cyclophosphamide) with FAC (5-fluorouracil, doxorubicin, cyclophosphamide) in the adjuvant treatment of node positive breast cancer patients.
        Proc. Am. Soc. Clin. Oncol. 2002; : 2136a
        • Citron M.
        • Berry D.A.
        • Cirroncione C.
        • et al.
        Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer.
        J. Clin. Oncol. 2003; 21: 1431-1439
        • Goldhirsch A.
        • Gelber R.D.
        • Castiglione M.
        The magnitude of endocrine effects of adjuvant chemotherapy for premenopausal breast cancer patients. The International Breast Cancer Study Group.
        Ann. Oncol. 1990; 1: 183-188
        • Bianco A.R.
        • Del Mastro L.
        • Gallo C.
        • et al.
        Prognostic role of amenorrhea induced by adjuvant chemotherapy in premenopausal patients with early breast cancer.
        Br. J. Cancer. 1991; 63: 799-803
        • Jonat W.
        Zoladex versus CMF adjuvant therapy in pre/peri-menopausal breast cancer.
        Proc. Am. Soc. Clin. Oncol. 2000; 19: 87a
        • Richards M.A.
        • O'Reilly S.M.
        • Howell A.
        • et al.
        Adjuvant cyclophosphamide, methotrexate, and fluorouracil in patients with axillary node-positive breast cancer.
        J. Clin. Oncol. 1990; 8: 2032-2039
        • Goodwin P.J.
        • Ennis M.
        • Pritchard K.I.
        • Trudeau M.
        • Hood N.
        Risk of menopause during the first year after breast cancer diagnosis.
        J. Clin. Oncol. 1999; 17: 2365-2370
        • Boccardo F.
        • Rubagotti A.
        • Amoroso D.
        • et al.
        Cyclophosphamide, methotrexate, and fluorouracil versus tamoxifen plus ovarian suppression as adjuvant treatment of estrogen receptor-positive pre-/perimenopausal breast cancer patients.
        J. Clin. Oncol. 2000; 18: 2718-2727
        • Jakesz R.
        • Hausmaninger H.
        • Kubista E.
        • et al.
        Randomized adjuvant trial of tamoxifen and goserelin versus cyclophosphamide, methotrexate, and fluorouracil.
        J. Clin. Oncol. 2002; 20: 4621-4627
        • Jonat W.
        • Kaufmann M.
        • Sauerbrei W.
        • et al.
        Goserelin versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy in premenopausal patients with node-positive breast cancer.
        J. Clin. Oncol. 2002; 20: 4628-4635
        • Davidson N.E.O.N.A.
        • Vukov A.
        • et al.
        Effect of chemohormonal therapy in premenopausal, node+, receptor+ breast cancer.
        Proc. Am. Soc. Clin. Oncol. 1999; 18: 67a
        • Bines J.
        • Oleske D.
        • Cobleigh M.
        Ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer.
        J. Clin. Oncol. 1996; 14: 1718-1729
        • Meirow D.
        Ovarian injury and modern options to preserve fertility in female cancer patients treated with high dose radio-chemotherapy for hemato-oncological neoplasias and other cancers.
        Leuk. Lymph. 1999; 33: 65-76
        • Del Mastro L.
        • Venturini M.
        • Sertoli M.R.
        • Rosso R.
        Amenorrhea induced by adjuvant chemotherapy in early breast cancer patients.
        Breast Cancer Res. Treat. 1997; 43: 183-190
        • Lower E.
        • Blau R.
        • Gazder P.
        • Tummala R.
        The risk of premature menopause induced by chemotherapy for early breast cancer.
        J. Womens Health Gen. Based Med. 1999; 8: 949-954
        • Hortobagyi G.N.
        • Buzdar A.U.
        • Marcus C.E.
        • Smith T.L.
        Immediate and long-term of adjuvant chemotherapy regimens containing doxorubicin in trials at M.D. Anderson Hospital and Tumor Institute.
        NCI Monogr. 1986; 1: 105-109
        • Fox K.
        • Ball J.E.
        • Mick R.
        • Moor H.C.F.
        Prevention of chemotherapy-associated amenorrhoea with Leuprolide in young women with early-stage breast cancer.
        Proc. Am. Soc. Clin. Oncol. 2001; 20: 25a
        • Recchia F.
        • Sica G.
        • De Filippis S.
        • Saggio G.
        • Rosselli M.
        • Rea S.
        Goserelin as ovarian protection in the adjuvant treatment of premenopausal breast cancer.
        Anticancer Drugs. 2002; 13: 417-424
        • Lishner M.
        Cancer in pregnancy.
        Ann. Oncol. 2003; 14: 31-36
        • MH Max T.K.
        Pregnancy and breast cancer.
        South Med. J. 1983; 76: 1088-1090
        • Zemlickis D.L.M.
        • Degenforfer P.
        Maternal and fetal outcome after breast cancer in pregnancy.
        Am. J. Obstet. Gynecol. 1992; 166: 781-787
        • Clark R.M.
        • Reid J.
        Carcinoma of the breast in pregnancy and lactation.
        Int. J. Radiat. Oncol. Biol. Phys. 1978; 4: 693-698
        • Bonnier P.
        • Romain S.
        • Dilhuydy J.M.
        Influence of pregnancy on the outcome of breast cancer.
        Int. J. Cancer. 1997; 72: 751-755
        • Petrek J.
        Breast cancer during pregnancy.
        Cancer. 1994; 74: 518-527
        • Doll D.
        Antineoplastic agents and pregnancy.
        Semin. Oncol. 1989; 16: 337-346
        • Tretli S.K.G.
        • Thoreson S.
        Survival of breast cancer patients diagnosed during pregnancy and lactation.
        Br. J. Cancer. 1988; 58: 382-384
        • Difronzo L.A.O.C.T.
        Breast cancer in pregnancy and lactation.
        Surg. Clin. North. Am. 1996; 76: 267-278
        • Gelber S.
        • Coates A.S.
        • Goldhirsch A.
        • et al.
        Effect of pregnancy on overall survival after the diagnosis of early-stage breast cancer.
        J. Clin. Oncol. 2001; 19: 1671-1675
        • Northouse L.L.
        Breast cancer in younger women.
        J. Natl. Cancer Inst. Monogr. 1994; 16: 183-190
        • Farash J.
        Effect of counselling on resolution of loss and body image following a mastectomy.
        Diss Abstr Int. 1979; 39: 4027B
        • Lee P.
        The psychological impact of cancer.
        Dis Abstr Int. 1981; 41: 3625B
        • Van den Borne H.
        • Pruyn J.
        • Van den Heuvel W.J.
        Effects of contracts between cancer patients on their psychosocial problems.
        Patient Educ Counsell. 1987; 1: 33-51
        • Schain W.S.
        • d'Angelo T.M.
        • Dunn M.E.
        • Lichter A.S.
        • Pierce L.J.
        Mastectomy versus conservative surgery and radiation therapy. Psychosocial consequences.
        Cancer. 1994; 73: 1221-1228
      2. Council NHaMR. Familial Aspects of Cancer: A Guide to Clinical Practice. Commonwealth of Australia, Canberra, 1999.

        • Easton D.F.
        • Ford D.
        • Bishop D.T.
        Breast and ovarian cancer incidence in BRCA1-mutation carriers. Breast Cancer Linkage Consortium.
        Am. J. Hum. Genet. 1995; 56: 265-271
        • Li F.P.
        • Fraumeni Jr., J.F.
        Soft-tissue sarcomas, breast cancer, and other neoplasms. A familial syndrome?.
        Ann. Intern. Med. 1969; 71: 747-752
        • Nelen M.R.
        • Padberg G.W.
        • Peeters E.A.
        • et al.
        Localization of the gene for Cowden disease to chromosome 10q22-23.
        Nat. Genet. 1996; 13: 114-116
        • Miller A.
        Screening by breast self examination.
        in: Jatoi I. Breast Cancer Screening. Springer, New York1997
        • Burke W.
        • Daly M.
        • Garber J.
        • et al.
        Recommendations for follow-up care of individuals with an inherited predisposition to cancer. II. BRCA1 and BRCA2. Cancer Genetics Studies Consortium.
        Jama. 1997; 277: 997-1003
        • Kerlikowske K.
        • Grady D.
        • Rubin S.M.
        • Sandrock C.
        • Ernster V.L.
        Efficacy of screening mammography. A meta-analysis.
        Jama. 1995; 273: 149-154
        • Robson M.E.
        • Morris E.
        • Kauff N.
        • et al.
        Breast cancer screening utilizing magnetic resonance imaging (MRI) in carriers of BRCA mutations.
        Proc. Am. Soc. Clin. Oncol. 2003; 22: 91
        • Kuhl C.K.
        • Schrading S.
        • Leutner C.C.
        Surveillance of “high risk” women with proven or suspected familial (hereditary) breast cancer.
        Proc. Am. Soc. Clin. Oncol. 2003; 22: 2
        • Kriege M.
        • Brekelmans C.T.M.
        • Boetes C.
        • et al.
        MRI screening for breast cancer in women with high familial and genetic risk.
        Proc. Am. Soc. Clin. Oncol. 2003; 22: 2
        • Diller L.
        • Medeiros Nancarrow C.
        • Shaffer K.
        • et al.
        Breast cancer screening in women previously treated for Hodgkin's disease.
        J. Clin. Oncol. 2002; 20: 2085-2091
        • Bhatia S.
        • Robison L.L.
        • Oberlin O.
        • et al.
        Breast cancer and other second neoplasms after childhood Hodgkin's disease.
        N. Engl. J. Med. 1996; 334: 745-751