Breast cancer screening among childhood cancer survivors treated without chest radiation: Clinical benefits and cost-effectiveness
Journal of the National Cancer Institute — Yeh JM, Lowry KP, Schechter CB, et al. | July 30, 2021
High-risk women, including survivors of childhood cancer treated with chest radiation, are recommended to receive early initiation of breast cancer screening. Researchers herein examined the potential clinical benefits and cost-effectiveness of early breast cancer screening among female survivors of childhood leukemia or sarcoma treated without chest radiation. Two Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer simulation models were adapted to predict the raised risks of breast cancer and competing mortality among leukemia and sarcoma survivors. Across models, the lifetime risk of dying from breast cancer among survivors was 6.8% to 7.0% in the absence of screening. Among these survivors, early initiation of breast cancer screening at age 40 may lead to reduction in breast cancer deaths by half and is cost-effective. Considering these findings, screening guidelines could be generated for survivors treated without chest radiation.