Women treated with chest radiation for a paediatric malignancy face a significantly increased risk of breast cancer at a young age. “The risk begins to increase as early as eight years after radiation and the median age of breast cancer diagnosis ranges from 32 to 35 years,” the authors write. By age 45 years, it is estimated that from twelve percent to 20 percent of women treated with moderate- to high-dose chest radiation will be diagnosed with breast cancer.
Researchers conducted a study that included 625 women, age 25 through 50 years, who had survived paediatric cancer, had been treated with chest radiation and were participating in the Childhood Cancer Survivor Study (CCSS). Participants received a 114-item questionnaire. Comparisons were made with similarly aged paediatric cancer survivors not treated with chest radiation and the siblings of the CCSS group. Of 1,976 cancer survivors and siblings who were contacted, 87.9 percent participated.
Among women age 25 through 39 years who had received chest radiation therapy (RT), 36.5 percent reported a screening mammogram within the past two years; 47.3 percent had never had a mammogram; and only 23.3 percent had a screening or diagnostic mammogram within the previous year.
Women age 40 through 50 years who had received chest RT were more likely to report mammography than their younger counterparts, with 76.5 percent reporting a screening mammogram within the past two years compared with 70.0 percent for the group without chest RT and 67.0 percent for the CCSS sibling group. 52.6 percent of women in this age group with chest RT had regular screening.
In all groups, women who were older were more likely to have been screened. For each 5-year incremental increase in age, the likelihood of reporting a mammogram increased nearly twofold. The strongest predictor of mammography in women ages 25 through 39 years was having a physician recommend the test.
“Our study suggests that most young women at risk of breast cancer following chest radiation for a paediatric cancer are not being appropriately screened. Findings from this study should provide the foundation for targeted interventions,” the authors conclude.
MEDICA.de; Source: American Medical Association (AMA)