Risk for Breast Cancer after Treatment for Childhood Cancer

Dava Szalda, MD MSHP
Last Modified: May 12, 2017

What’s the risk? 

Breast cancer risk can be increased after radiation therapy that includes the anterior chest wall, even in patients who have not yet developed breasts. This risk is highest when patients are treated with radiation fields that include the chest (like mediastinal radiation). The risk may also be increased with other types of radiation such as total body radiation or craniospinal radiation. 

Modern therapy and radiation techniques have limited the amount of radiation that normal tissues receive, so over time the risk may be less than than that observed in current adult survivors of childhood cancer.

When a risk is present, the increased risk of breast cancer usually does not occur until the mid-20s and/or at least 8 years after radiation therapy.

Symptoms/When to Call

Any woman who has a history of radiation treatment involving the chest should be aware of what e normal breast tissue feels like and alert their medical team if they notice a new lump or bump for them.

Prevention and Treatment

There are recommendations for early (earlier than the general population) screening in women who have had chest radiation in childhood. The screening depends on your field and dose of radiation so it is important to talk to your medical team or a specialized survivorship center to understand what your screening plan should be. When breast cancer screening does begin early, it usually begins in the mid-20s or 8 years after radiation exposure (whichever occurs later).

In addition, anyone with radiation exposure should know what their breasts feel like and talk to their medical team about self and clinical breast exams.

General cancer prevention strategies should also be used including healthy diet, physical activity, avoidance of tobacco use and knowing your family history of cancer.

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