Many Women Who Got Chest Radiation as Children Aren’t Getting Needed Breast Cancer Screening

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Radiation therapy to the chest area can be used to treat some types of childhood cancers. Still, children who receive radiation to the chest area may have a much higher risk of breast cancer later in life. Scientists estimate that about 20% of women who got childhood chest radiation will develop breast cancer by age 45. So doctors recommend a specialized breast cancer screening plan starting at an earlier-than-average age for women with a history of radiation therapy to the chest.

A study found that many women who got chest radiation therapy to treat childhood cancer are not getting the breast cancer screening they need based on their medical history.

Routine breast cancer screening with a mammogram is recommended starting at age 40 for women with average risk. Because breast cancer risk is much higher in women who received childhood chest radiation therapy, it's recommended that these women get both a mammogram and an MRI (magnetic resonance imaging) study each year, starting at age 25 or 8 years after receiving radiation therapy (whichever happens later).

In the study reviewed here, the researchers asked 625 women treated with chest radiation for childhood cancer whether and how often they were screened for breast cancer during the 2 years before the study. The women were between the ages of 25 and 50 during the study. The researchers compared this screening information with the screening information of the women's sisters, as well as the screening information of other women who were treated for childhood cancer but didn't receive radiation therapy to the chest.

The results:

  • Only 55% of the women who received childhood chest radiation therapy had been screened for breast cancer with a mammogram in the 2 years before the study. More than 45% of the women had not been screened in 2 years. According to current recommendations, all of these women should have been screened during the 2 years.
  • Younger women who had received chest radiation therapy were the least likely to have been screened as recommended. Only 36.5% of women aged 25 to 39 were screened for breast cancer during the 2 years before the study, compared to 76.5% of the women aged 40 to 50.
  • Many of the younger women (almost 50%) had NEVER been screened for breast cancer.
  • Even though the women aged 40 to 50 were more likely to have been screened in the 2 years before the study, only slightly more than half of them got regular screenings. "Regular" screening means at least two screenings in the 4 years before the study.
  • Overall, the women who had received childhood chest radiation had higher breast cancer screening rates than the other two groups of women. So some of the women did understand they needed more aggressive breast cancer monitoring.
  • A woman was much more likely to have the recommended breast cancer screening when her doctor specifically recommended a more aggressive screening plan.

Some of the biggest successes in cancer care have been in treating childhood cancer. Still, radiation used to treat childhood cancer also may affect normal cells nearby, causing a new, different cancer to develop many years later. Chest radiation therapy can unintentionally alter normal breast cells, increasing the risk that these breast cells may become breast cancer later in life.

If you've been treated for cancer in the past, it's very important that you regularly see a doctor who's familiar with your medical history and understands the special risks you face. Together, you and your doctor can create the counseling and screening plan that's best for you.

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