Some women at greater risk of breast cancer, after X rays, mammograms
X-ray, mammogram radiation may increase breast cancer risk for some
women http://www.myfoxphilly.com/story/19482704/x-ray-mammogram-radiation-may-increase-breast-cancer-risk-for-some-women Sep 07, 2012 Exposure to radiation is an established risk factor for breast cancer among all women, the study authors pointed out. — Women with certain gene mutations are more likely to develop breast cancer if they were exposed to radiation from chest X-rays or mammograms before age 30, compared with those who have the gene mutations and weren’t exposed to radiation, new research suggests.
The study included nearly 2,000 women, 18 and older, in the
Netherlands, France and the United Kingdom. All of the women had a
mutation in the BRCA1 or BRCA2 genes, which have long been linked to
raised risks for breast and ovarian cancer.
Forty-eight percent of the women reported ever having an X-ray and 33
percent had undergone a mammogram, according to the report published
online Sept. 7 in the BMJ. The average age at first mammogram was 29.
Between 2006 and 2009, 43 percent of the women were diagnosed with
breast cancer. A history of any exposure to radiation from chest
X-rays or mammograms between age 20 and 29 increased the risk of
breast cancer by 43 percent, and any exposure before the age of 20
increased the risk by 62 percent, the researchers found. Exposure
between ages 30 and 39 did not increase the risk of breast cancer,
For every 100 women, age 30, with BRCA1/BRCA2 mutations, nine will
have developed breast cancer by the age of 40, and the number of cases
of breast cancer in these women would have increased by five if all of
them had had one mammogram before age 30, according to calculations by
Anouk Pijpe of the Netherlands Cancer Institute and colleagues.
However, this estimate “should be interpreted with caution because
there were few women with breast cancer who had had a mammogram before
age 30 in the study,” the researchers explained in a journal news
Pijpe and colleagues recommended that non-ionizing radiation imaging
techniques, such as MRI, be used for women who carry these BRCA1/BRCA2
Exposure to radiation is an established risk factor for breast cancer
among all women, the study authors pointed out. Some countries
recommend that women under age 30 avoid mammography breast cancer
screening. Experts in the United States said the study raises many
“The authors should be applauded for carrying out such a complex study
in a concerted effort,” said Dr. Aye Moe Thu Ma, director of breast
surgery at St. Luke’s Roosevelt Hospital in New York City. The study
“brings into question the current National Comprehensive Cancer
Network guidelines on the use of mammograms for BRCA patients as early
at 25 years of age,” she added.
Ma also agreed that for patients who carry the BRCA gene mutations and
who have not undergone mastectomy, “they may be best to be screened
with MRI if the patients are younger than 30 and after discussing the
risks and benefits of the MRI with the patient.”
Another breast cancer specialist agreed that screening these patients
may require a tailored approach.
“Women with BRCA mutations should adhere to a screening program
designed specifically for them based on personal and family risk
factors, in addition to accounting for their BRCA status, so that they
may maximize benefit derived from screening and minimize any potential
risks,” said Dr. Eva Chalas, chief of clinical cancer services at
Winthrop University Hospital, in Mineola, N.Y.
And Ma also stressed that, “this study is focused on a small group of
high-risk patients who are sensitive to radiation, and does not apply
to the general public.”
Experts currently disagree on the recommended frequency of screenings
and the intervals between them. In 2009, the U.S. Preventive Services
Task Force ignited debate when it recommended screening mammograms
every two years for women ages 50 to 74. It advised women in their 40s
at average risk of breast cancer to discuss the pros and cons with
their doctors and then decide about the value of screening. Other
organizations, including the American Cancer Society, continue to
advise women 40 and older to get yearly screening mammograms.
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