To characterize the breast cancer surveillance practices among female pediatric cancer survivors who were treated with chest radiation and identify correlates of screening.
Breast cancer surveillance practices, including screening and diagnostic mammograms, were characterized using 25 questions adapted from the National Health Interview Survey 2000 Cancer Control Module .
- yearly clinical breast examination from the age of puberty until age 25 years, and then every 6 months if the survivor was treated with irradiation of at least 20 Gy to mantle, minimantle, mediastinal, chest (thoracic), or axillary fields
- annual mammography and an adjunct breast magnetic resonance imaging (MRI) starting at age 25 years or 8 years after radiation, whichever is last
Results from the survey showed
Among women aged 25-39 years with chest RT
- only 36.5% reported a screening mammogram within the past 2 years
- 47.3% of had never had a mammogram
- only 23.3% of had a screening or diagnostic mammogram within the previous year
- 76.5% reporting a screening mammogram within the past 2 years
- only 52.6% engaged in regular screening (at least 2 mammograms within 4 years)
- Age was an important predictor of screening mammography. For each 5-year incremental increase in age, the likelihood of reporting a mammogram increased nearly 2-fold.
- The strongest predictor of mammography in women aged 25 through 39 years was having a physician recommend the test.
Barriers to having screening mammogram
The 2 most important barriers ranked by women in this age group who did not have a mammogram in the previous 2 years were "put it off" or "didn't get around to it" (27%) and "too expensive" or "no insurance/cost" (17%).
This article is an important reminder of the ongoing health issues of childhood cancer survivors.
Breast Cancer Surveillance Practices Among Women Previously Treated With Chest Radiation for a Childhood Cancer; JAMA. 2009;301(4):404-414.; Kevin C. Oeffinger, Jennifer S. Ford, Chaya S. Moskowitz, Lisa R. Diller, Melissa M. Hudson, Joanne F. Chou, Stephanie M. Smith, Ann C. Mertens, Tara O. Henderson, Debra L. Friedman, Wendy M. Leisenring, and Leslie L. Robison
Surveillance for Breast Cancer After Childhood Cancer (editorial); JAMA. 2009;301(4):435-436; Aliki J. Taylor, MD, MPH, PhD; Roger E. Taylor, MD, MA
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