Derby results and practical experience of breast imaging in women following supradiaphragmatic irradiation for Hodgkin's disease

The national recall programme for women who had supradiaphragmatic irradiation for Hodgkin's disease under the age of 30 years began in late 2003. In Derby, from an initial identified group of 56 women, 36 attended for a 1-hour consultation with a consultant oncologist. From these 36 women, 33 have attended for surveillance.

In the group offered imaging surveillance, all 33 women took up the invitation. When magnetic resonance imaging (MRI) is indicated, it is done first; then the woman attends for mammography, MRI results and any focused ultrasound needed the following day.

See Table 1 for results. Five of the six MRI recalls were from a first screen, and the other from a second screen. One ductal carcinoma in situ was diagnosed in a lady with breast implants.

Table 1

From the 56 eligible women, there were four with breast cancer: one woman diagnosed as above, two women from the National Health Service Breast Screening Programme and one woman symptomatically in 2007. The radiology and pathology of these cases will be presented.

We commence family history screening with MRI soon and plan to apply this method, which works very well and within tight time limits.