Breast cancer is a recognized complication of chest irradiation for childhood cancer,1,2 and surveillance for breast cancer with regular clinical examination and annual screening mammography starting at age 25 years or 8 years after radiation is recommended.3 However, uptake of screening mammograms in this high-risk group is suboptimal, as shown in the report by Oeffinger and colleagues4 in this issue of JAMA. The authors examined breast cancer surveillance practices in a survey of 625 female survivors of pediatric cancer who were between 25 and 50 years and participants in the longitudinal Childhood Cancer Survivor Study (CCSS).5 These survivors were at a significantly increased risk of breast cancer as a result of treatment they received in the form of moderate- to high-dose (>20 Gy) irradiation to the chest for treatment of a childhood cancer (chest RT group). The women in the chest RT group were compared with 639 similarly aged CCSS participants who did not receive chest irradiation and with 712 siblings in the CCSS siblings cohort.
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