Childhood Cancer Survivors Need Mammograms

Experts say female childhood cancer survivors who have had radiation should get mammograms earlier than the general population of women.

Almost half of female childhood cancer survivors under the age of 40 who had chest radiation as part of their treatment are not following this recommended advice.

Physicians suggest starting screening mammograms at age 25, or eight years after the last radiation treatment, whichever comes last.

These guidelines are in place because women who have had chest radiation as children, teens, or young adults have a significantly higher risk for breast cancer.

Risk Begins Eight Years after Radiation
Results of the study were reported in the Journal of the American Medical Association.

"Although the majority of women who've had chest radiation will never have breast cancer, between 12 and 20 percent will have breast cancer by age 45," says study author Dr. Kevin Oeffinger, director of the program for adult survivors of pediatric cancer at Memorial Sloan-Kettering Cancer Center in New York City.

"When we looked at how frequently these women were having breast cancer screening, we found that only 37 percent of women age 25 to 39 had been screened in the last two years,” he notes. “In women between 40 and 50, about 77 percent had been screened in the last two years, but most were not in a regular pattern of screening.”

The risk of developing breast cancer begins as soon as eight years after radiation treatment ends. Those at highest risk of breast cancer are women who survived Hodgkin lymphoma through treatment with high-dose radiation.

However, any woman who received radiation for cancer treatment as a child is at increased risk, as are women who received radiation prior to heart-lung transplants, notes Dr. Freya Schnabel, director of breast surgery at the New York University Cancer Institute.

Dr. Oeffinger's study included 551 randomly selected women who had survived a pediatric cancer and had undergone chest radiation as part of their treatment.

Overall, 55 percent of the women reported having a screening mammogram during the past two years. Forty-seven percent of those under 40 had never had a screening mammogram.

Only 53 percent of those between 40 and 50 years old participated in regular mammogram screenings.

The study found that screening rates were three times higher among women whose physicians recommended the test.

Tell Your Doctor about Cancer History
Dr. Oeffinger says many different factors could account for why these women are not being screened.

"These are women who were treated in the 70s and 80s, largely before we had survivor programs, and they weren't given treatment summaries," he explains.

And, only about 20,000 to 25,000 women across the US are affected, most physicians will only have one patient or less who has survived a childhood cancer and had chest radiation.

Dr. Schnabel recommends that when "women transition to an adult practitioner, make sure you let them know what your pediatric diagnosis was, and the details of your treatment.

“And you need to be aware that having this radiation does put you at an increased risk of breast cancer, and if you have any family history of breast cancer, it's even more important to get screened," she emphasizes.

Always consult your physician for more information.

Online Resources

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American Cancer Society

National Alliance of Breast Cancer Organizations

National Breast Cancer Coalition

National Cancer Institute (NCI)

People Living With Cancer