REATMENT OF HODGKIN DISease (HD) represents one of the major medical successes of the 20th century. Fifty years ago, the typical patient survived only a few years, 1 whereas the current 5-year relative survival rate is 85%. 2 In the United States alone, approximately 120000 survivors of HD 2 are at risk for the serious late sequelae of curative therapies, including the occurrence of new primary cancers. 3,4 Second malignant neoplasms are now the leading cause of death in longterm survivors of HD, 5,6 with breast cancer representing the most frequent solid tumor among women. 7,8 Estimates of breast cancer risk appear inversely related to age at treat-Author Affiliations are listed at the end of this article.

Breast cancer projections varied considerably by type of HL therapy, time since HL diagnosis, and age at end of follow-up. These estimates are applicable to HL survivors treated with regimens of the past and can be used to counsel such patients and plan management and preventive strategies. Projections should be used with caution, however, in patients treated with more recent approaches, including limited-field radiotherapy and/or ovary-sparing chemotherapy.