- Female childhood cancer survivors face an increased risk for breast cancer, according to the St Jude Lifetime Cohort Study.
Why this matters
- Surveillance imaging is necessary in this population, preferably with dual imaging (MRI/mammography).
- Higher doses of anthracyclines and chest irradiation are commonly used to treat lymphoma.
- Prospective cohort of 1467 women aged ≥18 years, 10 years postchildhood cancer diagnosis.
- Funding: NIH; other.
- 56 women developed 68 breast cancers (primarily invasive and in situ) at a median age of 38.6 years, with cumulative incidence at age 35 years of 1% (no chest irradiation) and 8% (≥10 Gy of chest irradiation).
- Breast cancer was associated with:
- ≥20 Gy of chest irradiation (vs none; aHR, 7.6; P<.001>
- Anthracycline exposure (vs none; 1-249 mg/m2: aHR, 2.6 [P=.034]; ≥250 mg/m2: HR, 13.4 [P<.001>
- Having a breast cancer predisposition gene (e.g., BRCA1, BRCA2, and TP53) vs none (aHR, 23.0; P<.001>
- Radiation dosimetry is only available for the chest, not the breast.