Early breast cancer screening in childhood cancer survivors treated with chest radiation may reduce deaths by more than 50.

Abstract

The early initiation of annual breast cancer screening with magnetic resonance imaging (MRI) among survivors of childhood cancer who have been treated with chest radiation may reduce their breast cancer mortality risk by at least 50% according to a new study published in the Annals of Internal Medicine.1 Girls who receive chest radiation for childhood cancer are at increased risk for breast cancer. Indeed, research suggests that as many as 30% develop the disease by the age of 50 years. Nonetheless, there are various schools of thought regarding how and when to monitor for the disease in these survivors. In an effort to determine the best screening strategies for this population, investigators used modeling to compare the results of different strategies. Corresponding author Jennifer Yeh, PhD, an assistant professor of pediatrics at Harvard Medical School and an associate scientific researcher in the Division of General Pediatrics at Boston Children's Hospital, and colleagues across the country used 2 breast cancer simulation models that were developed to guide screening recommendations for non–breast cancer survivors. The models are part of the Cancer Intervention and Surveillance Modeling Network and were adapted with information from the Childhood Cancer Survivor Study, a cohort study following outcomes in more than 24,000 survivors of childhood and adolescent cancers. One study limitation was that the data came from childhood cancer survivors diagnosed between 1970 and 1986. Cancer treatment has evolved since then to incorporate decreased doses and improved delivery of radiation as well as digital mammography screening. Nonetheless, results show that early screening can save lives, Dr. Yeh says.