Jun 06, 2012 - 4:25 pm
I just recently found this on Wall Street Journal about Wilm's Tumor survivors.
Chest Radiation for Girls Is Linked to Breast Cancer Later
CHICAGO—Women who were exposed to chest radiation to treat cancer during childhood have a risk of developing breast cancer as adults that is comparable to that of women with a high genetic risk of the disease, according to a study being presented Monday.
Researchers analyzed data from 1,268 women who survived childhood cancer treated between 1970 and 1986 and found that by age 50, 24% had been diagnosed with breast cancer. About 31% of women who carry a mutation in the BRCA1 gene, well known for its link to higher risk, are diagnosed with the disease by that age.
Chaya Moskowitz, a researcher at Memorial-Sloan Kettering Cancer Center and lead author of the study, noted that while previous research has linked childhood radiation therapy to risk of breast cancer, it hasn't previously been shown that the risk "is remarkably similar" for women with a BRCA mutation. Many women are unaware of the high level of risk, she said. She is presenting the results Monday at the annual meeting of the American Society of Clinical Oncology.
"These are rather striking data," said Nicholas Vogelzang, a partner of Comprehensive Cancer Centers of Nevada, who wasn't involved in the study. He said the findings call for careful follow-up and attention to mammography and other screening for such women.
The risk was related to levels of exposure as measured by a metric called gray. Guidelines developed by the National Cancer Institute-sponsored Children's Oncology Group call for women exposed during childhood to 20 grays or more of radiation to begin regular annual checkups, including mammography and breast MRI exams, at age 25. But women exposed to between 10 and 19 grays are also at a significantly higher risk than the general population and may benefit from a similar screening protocols, Dr. Moskowitz said. Such women aren't covered by current guidelines. About 50,000 women in the U.S. have been treated with 20 grays while another 9,000 have been exposed to between 10 and 19 grays.
Women who were treated for Hodgkin's lymphoma as children are at the highest risk, she said, with 30% getting diagnosed by age 50. Those with that cancer in the study were likely to have had treatment that involved radiating the entire breast. That approach isn't used in current treatment. But women with Hodgkin's Lymphoma or other cancers, including Wilm's tumor and neuroblastoma can still get significant levels of radiation.
"We still want to cure the childhood cancer," Dr. Moskowitz said. "We want to maximize the cure while reducing" the amount of exposure as much as possible.
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