Second malignant neoplasms following treatment for Wilms tumor. M.D. Several studies have shown that women treated with radiation to the chest for childhood Hodgkin's disease have an increased risk of developing breast cancer as they get older. Researchers are studying this problem to better understand the risk factors and find ways to prevent secondary breast cancer. The risk of secondary breast cancer is related to dose of radiation and may be related to age at treatment and family history. Patients treated with the higher doses of radiation have the highest risk.
Some studies show that girls irradiated during puberty are also at increased risk.
However, information about this is limited because no studies have been done in large groups of childhood cancer survivors. The risk of secondary breast cancer becomes elevated five to nine years following radiation therapy and continues to rise after 10 years. Hodgkin's survivors treated with radiation therapy should perform monthly breast self-examination to increase awareness about breast changes during the menstrual cycle and to monitor for changes suspicious for cancer. They should have breast exams by their doctors twice a year, and a baseline mammogram five to 10 years after radiation. At St. Jude, where I practice, we do the baseline mammogram at age 25 years.