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More female childhood cancer survivors treated with chest radiation may benefit from breast cancer screening
CHICAGO — A greater percentage of female childhood cancer survivors who were treated with radiation to the chest may benefit from early screening for breast cancer, study results suggest.
Multiple studies have shown women treated with chest radiation for childhood cancer are at increased risk for developing breast cancer.
The Children’s Oncology Group recommends annual mammograms and breast MRI for women who received radiation doses of 20 Gy or more as children, adolescents or young adults. Those women are urged to undergo screening at age 25 years or 8 years after radiation treatment, whichever is last.
“What is remarkable about this study is that [the estimated 7,000 to 9,000 US] women who were treated with more moderate doses of radiation — 10 Gy to 19 Gy — also had an elevated risk of breast cancer,” Chaya S. Moskowitz, PhD, an associate attending biostatistician at Memorial Sloan-Kettering Cancer Center, said during a press conference. “According to the Children’s Oncology Group Guidelines, which are the standard of care in the United States and Canada, these women are not currently recommended for screening.”
Moskowitz and colleagues analyzed data from 1,268 women who participated in the Childhood Cancer Survivor Study. The women were 5-year childhood cancer survivors who had been treated with chest radiation.
Researchers also evaluated 4,570 female first-degree relatives of breast cancer patients who were enrolled in the Women’s Environmental Cancer and Radiation Epidemiology (WECARE) Study, which was open to women with breast cancer who survived for at least 1 year after diagnosis. This allowed researchers to compare the risk of breast cancer in childhood cancer survivors treated with chest radiation to the risk of breast cancer in another high-risk population, women who carry BRCA gene mutations, Moskowitz said during a press conference.
Seven percent of childhood cancer survivors who were treated with chest radiation doses of 10 Gy to 19 Gy developed breast cancer by age 40 years, compared with 12% of women treated with doses of 20 Gy or higher.
By age 50 years, 24% of all childhood cancer survivors evaluated in the study developed breast cancer. Approximately 30% of women treated with chest radiation for Hodgkin’s lymphoma were diagnosed with breast cancer, a rate that is “remarkably similar” to the 31% of women with BRCA1 mutations, Moskowitz said.
Women who underwent chest radiation for treatment of childhood cancers other than Hodgkin’s lymphoma showed a breast cancer risk similar to that of BRCA2 carriers, Moskowitz said.
“While radiation doses have decreased and techniques have improved, radiation is still an essential part of therapy for many childhood cancers,” Moskowitz said in a press release. “The goal is to maximize the cure rates for childhood cancer while minimizing future health problems.”
For more information:
Moskowitz CS. Abstract #CRA9513. Presented at: the 2012 American Society of Clinical Oncology Annual Meeting; June 1-5, 2012; Chicago.
Disclosure: The researchers report no relevant financial disclosures.
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