Breast Cancer in Women Who Survived Childhood Cancer

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The summary below is from the full report titled "Breast Cancer after Childhood Cancer: A Report from the Childhood Cancer Survivor Study." It is in the 19 October 2004 issue of Annals of Internal Medicine (volume 141, pages 590-597). The authors are L.B. Kenney, Y. Yasui, P.D. Inskip, S. Hammond, J.P. Neglia, A.C. Mertens, A.T. Meadows, D. Friedman, L.L. Robison, and L. Diller.

What is the problem and what is known about it so far?

Treatments for the types of cancer that affect children have become more effective over recent decades. As a result, an increasing number of people have survived childhood cancer. Unfortunately, survivors of childhood cancer are at risk for developing cancer again during adulthood. Sometimes, but not always, these second occurrences of cancer are the result of the cancer treatments they received as a child. Women who survived childhood or adolescent Hodgkin's disease (a cancer of the lymph nodes) have a higher risk for breast cancer than the general population of women. Radiation treatment to the chest is part of Hodgkin's disease treatment, and it clearly increases the risk for breast cancer later in life. However, reports also suggest that women who survived other types of childhood cancer may also be at risk for breast cancer. Better information about the factors that increase the risk for breast cancer among women who survived childhood cancer might help guide breast cancer screening in these women.

Why did the researchers do this particular study?

To find out more about risk factors for breast cancer in women who survived childhood cancer.

Who was studied?

6068 women who were participating in the Childhood Cancer Survivor Study. This study follows people from several medical centers who had childhood cancer diagnosed from 1970 to 1986 and survived at least 5 years after treatment.

How was the study done?

The researchers gathered information about each woman's childhood cancer, treatment, medical history, and family history. They compared women who did and did not develop breast cancer to try to identify factors that were associated with the development of breast cancer. They also compared the rates of breast cancer in the study women with the rates of breast cancer in the general population.

What did the researchers find?

Of the 6068 women in the study, 95 women developed breast cancer at a median age of 35 years. Women who had survived childhood sarcoma and those treated with chest radiation therapy had an increased risk for breast cancer. A family history of breast cancer and personal history of thyroid disease were also associated with an increased risk for breast cancer.

What were the limitations of the study?

This study does not address whether earlier or more frequent breast cancer screening would benefit female survivors of childhood cancer.

What are the implications of the study?

Among women who have survived childhood cancer, those with certain types of cancer, those who received chest radiation therapy, those with a family history of breast cancer, or those with thyroid disease have an increased risk for breast cancer. Future research should study the benefits of earlier or more intensive breast cancer screening in these women.