Pediatric cancer survivors don't get enough mammograms

Despite recommended guidelines, a number of women who received chest radiation for a childhood cancer have not had mammography screening for breast cancer in the previous 2 years, according to the results of a study published in the Jan. 28 issue of the Journal of the American Medical Association.

Kevin C. Oeffinger, MD, of the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues, determined the breast cancer surveillance practices among a cohort of women who had childhood cancer treated with chest radiation. A questionnaire was administered to 551 women between June 2005 and August 2006.

The investigators found that 63.5% of the women aged 25 to 39 years and 23.5% of women aged 40 to 50 years had not had a screening mammogram in the previous 2 years. Nearly half (47.3%) of the women under 40 years of age reported never having a mammogram, the researchers report. Age predicted screening mammography; the likelihood of reporting a mammogram nearly doubled for every 5-year increase in age. The strongest predictor for screening mammograms among young women (aged 25 to 39 years) was a physician recommendation, the authors note.

"The risk of breast cancer after exposure to annual low-dose irradiation in the form of x-ray mammography should be explored in future studies as well as the role of MRI as a replacement for x-ray mammography rather than as an adjunctive examination in this group of young women," the authors of an accompanying editorial write.

Oeffinger KC, Ford JS, Moskowitz CS, et al. Breast cancer surveillance practices among women previously treated with chest radiation for a childhood cancer. JAMA. 2009;301:404-414.