Higher doses of anthracyclines are associated with increased risk of breast cancer in women who survived childhood cancer, regardless of whether they have mutations that predispose them to cancer, according to findings based on the St. Jude Lifetime Cohort Study.
Breast cancers observed by imaging (n = 33) and prophylactic mastectomy (n = 7) were more likely to be treated without chemotherapy than those whose disease was diagnosed by physi-cal findings. Thus, patients with cancers detected by surveillance would likely have less of a need for chemotherapy. Investigators said their findings confirmed dual imaging to be a focused and specific approach to identifying subsequent cancer. They recommend screening survivors treated with high doses of anthracyclines in a manner consistent with those who have received radiation affecting the breast or have a known breast cancer predisposition mutation.
Table. Cumulative Incidence of Breast Cancer in Women Who Survived Childhood Cancer
Ehrhardt MJ, Howell CR, Hale K, et al. Subsequent breast cancer in female childhood cancer survivors in the St Jude Lifetime Cohort Study (SJLIFE) [published online May 10, 2019]. J Clin Oncol. doi: 10.1200/JCO.18.01099.
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