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The Oncologist, Vol. 2, No. 4, 228–234, August 1997
© 1997 AlphaMed Press

Screening Childhood Cancer Survivors for Breast Cancer

Emmanuella Joseph, Robert Clark, Claudia Berman, Marcia Miller, Charles Cox, Harvey Greenberg, Douglas S. Reintgen

The Comprehensive Breast Cancer Center, H. Lee Moffitt Cancer Center & Research Institute at the University of South Florida, Tampa, Florida, USA

Correspondence: Douglas S. Reintgen, M.D., Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, Florida 33612-9497, USA. Telephone: 813-972-8482; Fax: 813-979-7211.

The development of second primary solid tumors, especially breast neoplasms, is increased among patients who have survived childhood or adolescent malignancies. With the increased long-term survival of patients with pediatric cancer, questions regarding breast cancer screening in this group have been raised. At this time, there are no established guidelines for breast cancer surveillance in this high-risk population. The objective of this review is to summarize the incidence, list additional risk factors for the development of breast cancer, and discuss the benefits of early detection of second primary breast cancers in pediatric cancer survivors. We have devised an algorithm for breast cancer screening in survivors of childhood malignancy. Implications of treatment with radiation and chemotherapy and the influence on prognosis of genetic abnormalities such as p53 mutations are debated.

Key Words. Breast neoplasm/prevention and control • Second primary/epidemiology • Mass screening • Risk factors • Child • Time factors




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