Childhood cancer survivors miss needed mammograms

NEW YORK (Reuters Health) - Women who were treated with chest radiation for childhood cancer are at increased risk of early breast cancer, but many are not getting the screening tests experts recommend, researchers reported Tuesday.

It's estimated that between 12 percent and 20 percent of women treated with moderate- to high-dose radiation will be diagnosed with breast cancer by the age of 45. Because of this, experts advise these women to have yearly mammograms starting at age 25, or eight years after completing chest radiation therapy, whichever comes last.

But the new study, published in the Journal of the American Medical Association, suggests that many women are not being screened as they should be.

Of 551 U.S. and Canadian women who'd received chest radiation for childhood cancer, only 55 percent said they'd had a mammogram in the past two years. And among those younger than 40, nearly half had never had a mammogram.

The researchers had expected the mammography rate to be lower than it should be -- but not as low as it turned out to be, said lead researcher Dr. Kevin C. Oeffinger of Memorial Sloan- Kettering Cancer Center in New York.

"We think that these women aren't educated about this risk, and their primary care doctors aren't either," he told Reuters Health.

Most women with a history of childhood cancer are no longer seeing a cancer specialist, and their primary care providers may be unaware that those who'd received chest radiation need early, regular mammograms.

There are only about 20,000 to 25,000 U.S. women who fall into this category, Oeffinger explained, so most primary care doctors would have little experience with their particular medical needs.

Women should bring up the issue of screening mammography if their doctors have not yet done so, Oeffinger said. He also pointed out that for those who do develop breast cancer, the prognosis is good when it's caught early.

In general, childhood cancer survivors are at risk of a number of long-term health problems as a result of their treatments, including hormonal deficiencies and heart disease.

Oeffinger recommended that all adult survivors get in touch with their cancer center to formulate a "cancer treatment summary" to be passed on to their primary care doctor. These summaries include a list of the treatments the patient received as a child, along with the potential long-term health effects of each one.

SOURCE: Journal of the American Medical Association, January 28, 2009.