Chest radiation received during childhood may increase women’s odds of developing breast cancer. Yet, a new study in the Journal of the American Medical Association shows that these women do not undergo the yearly screening mammograms highly recommended by experts.

 

According to this recommendation, women who received moderate- to high-dose chest radiation for a pediatric cancer should undergo screening for breast cancer beginning either at age 25 or eight years after the treatment. (Normally, a woman has to undergo such examinations after the age of 40). Experts estimate that between 12 percent and 20 percent of these women will be diagnosed with breast cancer by the age of 45. These women are also exposed to hormonal deficiencies and heart disease as a result of radiation therapy during childhood.

 

Despite the recommendation, “most young women at risk of breast cancer following chest radiation for a pediatric cancer, including women at higher risk (Hodgkin lymphoma survivors), are not being appropriately screened,” said Kevin C. Oeffinger, MD, of Memorial Sloan-Kettering Cancer Center in New York, who led the study.

 

For the study, Dr. Oeffinger and colleagues studied data from a survey of 625 women who had survived childhood cancer and had received chest radiation as part of their treatment. The women were 25 to 50 when surveyed during 2005 and 2006 and were participating in the Childhood Cancer Survivor Study (CCSS).

 

The results were then compared with answers of 639 pediatric cancer survivors who did not get chest radiation and 712 siblings of the cancer survivors who had radiation therapy.

 

About 36.5 percent of women between 25 and 39 reported a screening mammogram within the past 2 years. Also, 47.3 percent had never had a mammogram and only 23.3 percent had a screening or diagnostic mammogram within the previous year.

 

These women were three times more likely to have had a mammogram if their doctor recommended one.

 

The study also found that women 40 to 50 were more likely to have had mammograms than those aged 25 to 39. About 76 percent had a screening mammogram in the past two years compared with 70 percent of women who did not receive chest radiation and 67 percent of sibling without history of childhood cancer. About 52 percent of them had regular breast cancer screening.

 

The results of the study clearly show that women need to be educated by their doctors about their risks of breast cancer after childhood chest radiation. Women should talk to their doctor about their situation and require a screening mammography if the doctors have not yet done so, Dr. Oeffinger said.

 

“Findings from this study should provide the foundation for targeted interventions involving both clinicians and cancer survivors,” the author concluded.