Patients not screened aptly for radiation induced breast cancer

New York, January 28: Chest radiationdefine therapy (RT) for pediatric cancerdefine puts young women treated with it at high risk of developing breast cancer, yet there is no substantial screening practice to check this possibility.

The women who had been treated with chest radiationdefine therapy to cure their childhood cancerdefine are likely to develop breast cancer as early as eight years after being exposed to moderate- to high-dose chest radiation.

A study conducted on 625 women ages between 25 and 50 years, who had undergone chest radiation therapy for pediatric cancer, showed that 36.5 percent women, ageing between 25 and 39 years, reported a screening mammogramdefine within the past 2 years, as against the recommended yearly screening.

Women who never had a mammogram were even higher in percentage at 47.3 percent. And lowest was the number of those who met the recommended annual screening at 23.3 percent. Most of these women, who went for screening, or who were likely to report screening in the next years, were advised by their physicians to do so. Doctors’ recommendation increased the likelihood of women going for screenings by three times.

On the brighter side, women, 40 to 50 years of age, were found having screened regularly in previous two years, and were two times more likely to go for mammograms with every 5 year increase in their age.

The study was conducted by Kevin C. Oeffinger, M.D., of Memorial Sloan-Kettering Cancer Center, New York, and colleagues, and the participants were compared with their siblings and those women cancer survivors who did not get radiation therapy.

In United States, about 25,000 women, age 25 and above, have gone through radiation therapy in their childhood to survive pediatric cancer. 12 to 20 percent of these women are likely to be diagnosed with breast cancer by the time they are 45.

Yearly screenings and mammograms are highly recommended by the experts, yet many women who have been treated with RT for childhood malignancy, are either skipping or are irregular in getting screened for breast cancer.

Appreciating the important points raised in the Oeffinger’s study, Aliki J. Taylor, M.D., M.P.H., Ph.D., of the University of Birmingham, and Roger E. Taylor, M.D., M.A., of Swansea University, were quoted as saying in an editorial, "These include the relatively low uptake of screening mammography in a high-risk population, the importance of clinician recommendation to improve the uptake of screening mammography, and the continuing need to educate clinicians and patients about the risks of breast cancer after chest irradiation in childhood through well-designed education programs.

“The risk of breast cancer after exposure to annual low-dose irradiation in the form of x-ray mammography should be explored in future studies as well as the role of magnetic resonance imaging as a replacement for x-ray mammography rather than as an adjunctive examination in this group of young women.

“In addition, it is important to explore whether the rate of screening uptake could be improved if survivors were provided with screening at no extra cost."

The study report is published in Jan. 28 issue of Journal of the American Medical Association.