In what medical experts are calling an “extraordinarily rare” case, four European women developed breast cancer years after receiving organ donations from a single donor, according to a report published Sept. 19 by CNN. 

The 53-year-old donor, who died in 2007 after a stroke, had no known medical conditions or malignancies when her kidneys, lungs, liver and heart were harvested for donation. Of the four women, three of them died of the disease, according to the CNN.  

Frederike Bemelman, MD, PhD, professor of nephrology at the University of Amsterdam and author of the case report published online in the April issue of the American Journal of Transplantation, explained that the malignancy was not detected during the screening process of the organ donor, including a breast exam and ultrasound of the abdomen and heart. 

“It is unclear whether a CT scan would have uncovered the donor's malignancy before the transplants, but Bemelman is doubtful,” according to CNN. “She warns against routine use of CT scans for all donors, as this would increase irrelevant findings and could lead to a decrease in the ‘very scarce’ donor pool.” 

Read CNN’s full report below.