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Mammography Surveillance for Childhood Cancer Survivors

Only about half received appropriate regular screening mammography.

As many as 20% of women who receive chest radiation for childhood cancer will develop breast cancer by age 45. Annual mammography is recommended for these women beginning at age 25 or 8 years after chest radiation exposure, whichever comes earlier. To assess adherence to this recommendation, researchers identified 625 women (age range, 25–50) who had received moderate-to-high-dose chest radiation for childhood cancer (mostly Hodgkin lymphoma, Wilms tumor, or neuroblastoma); 551 completed mail or telephone surveys.

Overall, roughly half of the participants had not undergone regular mammography screening (at least 2 mammograms in 4 years). Nearly half of the younger women (age range, 25–39) had never been screened, compared with 8% of the middle-aged women (age range, 40–50). Screening rates for the middle-aged women generally were the same as those for the age-matched controls who had never received chest radiation. Women who had primary care physicians or who received physician recommendations for mammography were more likely to receive appropriate screening.

Comment: In this study, women at high risk for breast cancer because of childhood chest radiation received inadequate mammographic surveillance. The job of improving surveillance falls to primary care physicians, who should be knowledgeable about the risk for breast cancer in this population as well as the need to start screening early.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine January 29, 2009

Citation(s):

Oeffinger KC et al. Breast cancer surveillance practices among women previously treated with chest radiation for a childhood cancer. JAMA 2009 Jan 28; 301:404.

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• survival benefit?
  K R Cabrera, 26 Mar 2009 10:55 AM EST
  In the same journal watch email is an article concluding that there is no benefit to mammographic screening for BRCA... [more]