I have a relative who married a man whose mother has the same first name as her. So, when she got married and took her husband's last name, she and her mother-in-law had the same name. And years ago, an associate of mine had the same name as her sister-in-law after she'd married her brother, but later her sister-in-law divorced my associate's brother and married someone else and took his last name.
These types of things probably happen a lot when a woman gets married and decides to take her husband's last name, and when it happens, the only options a woman has if she doesn't want to have the same name as one of her husband's relatives is to, of course, either not take her husband's last name or to hyphenate her maiden name with her new last name.