Surveillance for Breast Cancer in Women Treated with Chest Radiation for a Childhood, Adolescent or Young Adult Cancer: A Report from the Children's Oncology Group
Year: 2010
Type: article
Study design: Systematic Review
Abstract: BACKGROUND: Women treated with therapeutic chest radiation may develop breast cancer. PURPOSE: Summarize breast cancer risk and breast cancer surveillance in women following chest radiation for a pediatric or young adult cancer. DATA SOURCES: Studies from MEDLINE, EMBASE, Cochrane Library, and CINAHL (1966 through December 2008). STUDY SELECTION: Articles selected to answer any of 3 questions: 1) What is the incidence and excess risk of breast cancer in women following chest radiation for a pediatric or young adult cancer? 2) For these women, are the clinical characteristics of the breast cancer and the outcomes following therapy different than for women with sporadic breast cancer in the general population? 3) What are the potential benefits and harms associated with breast cancer surveillance among women exposed to chest radiation? DATA EXTRACTION: Three investigators independently extracted data and assessed study quality. DATA SYNTHESIS: Standardized incidence ratios ranged from 13.3 to 55.5; cumulative incidence of breast cancer by 40–45 years of age ranged from 13–20%. Risk of breast cancer increased linearly with chest radiation dose. Available limited evidence suggests that the characteristics of the breast cancers in these women and the outcomes following diagnosis are similar to those in the general population; these breast cancers can be detected by mammography, though sensitivity is limited. LIMITATIONS: Limitations include study heterogeneity, design and small sample size. CONCLUSIONS: Women treated with chest radiation have a substantially elevated risk of breast cancer at a young age, which does not appear to plateau. Among this high risk population, there appears to be a benefit associated with early detection. Further research is required to better define the harms and benefits of lifelong surveillance.
Source: PubMed Central
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W989619353