Systematic review: Surveillance for breast cancer in women treated with chest radiation for childhood, adolescent, or young adult cancer Journal Article

   


Authors: Henderson, T. O.; Amsterdam, A.; Bhatia, S.; Hudson, M. M.; Meadows, A. T.; Neglia, J. P.; Diller, L. R.; Constine, L. S.; Smith, R. A.; Mahoney, M. C.; Morris, E. A.; Montgomery, L. L.; Landier, W.; Smith, S. M.; Robison, L. L.; Oeffinger, K. C.
Article Title: Systematic review: Surveillance for breast cancer in women treated with chest radiation for childhood, adolescent, or young adult cancer
Abstract: Background: Women treated with therapeutic chest radiation may develop breast cancer. Purpose: To summarize breast cancer risk and breast cancer surveillance in women after chest radiation for pediatric or young adult cancer. Data Sources: Studies from MEDLINE, EMBASE, the Cochrane Library, and CINAHL (1966 to December 2008). Study Selection: Articles were selected to answer any of 3 questions: What is the incidence and excess risk for breast cancer in women after chest radiation for pediatric or young adult cancer? For these women, are the clinical characteristics of breast cancer and the outcomes after therapy different from those of women with sporadic breast cancer in the general population? 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 age 40 to 45 years ranged from 13% to 20%. Risk for breast cancer increased linearly with chest radiation dose. Available limited evidence suggests that the characteristics of breast cancer in these women and the outcomes after diagnosis are similar to those of women in the general population; mammography can detect breast cancer, although sensitivity is limited. Limitation: The quality of evidence for key questions 2 and 3 is limited by substantial study heterogeneity, variation in study design, and small sample size. Conclusion: Women treated with chest radiation have a substantially elevated risk for breast cancer at a young age, which does not seem to plateau. In this high-risk population, there seems to be a benefit associated with early detection. Further research is required to better define the harms and benefits of lifelong surveillance. © 2010 American College of Physicians.
Keywords: adolescent; adult; child; young adult; review; cancer risk; cancer radiotherapy; radiation dose; cancer incidence; breast cancer; radiotherapy dosage; incidence; odds ratio; risk factors; health survey; age factors; breast neoplasms; risk factor; hodgkin disease; time; time factors; age; risk; mammography; systematic review; neoplasms, radiation-induced; breast tumor; thorax radiography; radiation induced neoplasm
Journal Title: Annals of Internal Medicine
Volume: 152
Issue: 7
ISSN: 0003-4819
Publisher: American College of Physicians  
Date Published: 2010-04-06
Start Page: 444
End Page: 455
Language: English
PUBMED: 20368650
PROVIDER: scopus
PMCID: PMC2857928
DOI: 10.7326/0003-4819-152-7-201004060-00009
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-77951230094&partnerID=40&md5=39a425b1accbaee4c9f8d68236c84442
Notes: --- - "Cited By (since 1996): 5" - "Export Date: 20 April 2011" - "CODEN: AIMEA" - "Source: Scopus"
Altmetric
What is Altmetric?
Citation Impact
What is Dimensions Citation Badge?
BMJ Impact Analytics
MSK Authors
  1. Elizabeth A Morris
    336 Morris
  2. Leslie L Montgomery
    50 Montgomery
  3. Stephanie M Smith
    6 Smith
  4. Kevin Oeffinger
    296 Oeffinger
Related MSK Work