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FAQ - Increased risk of breast cancer after certain types of treatment for childhood cancer

In a new study, researchers found that women who were treated for cancer as children with a certain type of chemotherapy have an increased risk of breast cancer. We can imagine you have questions about this. Read the answers to frequently asked questions below. Is your question not among them? Contact communicatie@prinsesmaximacentrum.nl

Read the news article here.

About doxorubicin

How many children receive doxorubicin each year?

About 200 children a year are treated with doxorubicin.

Which children receive doxorubicin?

Doxorubicin is a form of chemotherapy that is part of the treatment for several types of childhood cancer.

Why do children receive doxorubicin?

Doxorubicin is a chemotherapy. It falls under the class of anthracyclines. These drugs stop fast-growing cells. Doxorubicin is given in several childhood cancers.

How long has doxorubicin been administered?

Doxorubicin has been used since the early 1970s.

Why has it never been studied before whether doxorubicin can increase the risk of breast cancer?

Like breast cancer in the general population, breast cancer following childhood cancer often occurs later in life. As a result, we have only now been able to properly study this in a large group of adults who previously had cancer as children.

About this study

How confident are you that doxorubicin can cause later breast cancer?

The results from this study show that breast cancer is more common in survivors who were treated with doxorubicin than in survivors who were not treated with doxorubicin. The researchers find that this risk was higher at higher doses, making it very likely that doxorubicin can cause later breast cancer.

Can you get breast cancer from chemotherapy other than doxorubicin?

The results from this study give no immediate reason to conclude that you can get breast cancer from chemotherapy other than doxorubicin.

Does it matter whether you had a high or low dose of doxorubicin or other anthracyclines?

Yes, the risk of breast cancer after treatment with doxorubicin depends greatly on the dose. The more of the drug you have had, the higher the subsequent risk of breast cancer.

What patient groups were examined for this study?

Different patient cohorts linked to different organizations were used within this study. Most of the data used in this study came from the cohorts at St Jude Children's Research Hospital. Organizations and cohorts involved:

  • Princess Máxima Center for pediatric oncology - Dutch Childhood Cancer Survivor Study LATER
  • St. Jude Children's Research Hospital - Childhood Cancer Survivor Study and St. Jude Lifetime Cohort Study
  • INSERM U1018, Gustave Roussy - French Childhood Cancer Survivor Study.
  • Netherlands Cancer Institute - Dutch Hodgkin Late Effects cohort
  • Institute of Social and Preventive Medicine, University of Bern - Swiss Childhood Cancer Survivor Study
For parents and children

If I want to know if my child has had doxorubicin, what should I do?

For information about your child's treatment, contact your child's doctor.

Will the pediatric cancer treatment protocol be modified now?

No, no adjustments to treatment protocols are taking place at this time because doxorubicin is a very important and effective part of treatment for various childhood cancers and because the dose has already been kept as low as possible to avoid long-term side effects. However, in the development of new treatment protocols, these trade-offs are made each time with all the knowledge available.

Will follow-up at the LATER outpatient clinic be modified?

Female survivors of childhood cancer who have been treated with radiation on the breast area are already screened for breast cancer according to the LATER guidelines. We will soon consider whether this screening guideline should be modified for female survivors of pediatric cancer treated with high-dose doxorubicin.

What if I want my child to stop receiving doxorubicin?

Doxorubicin is an important and effective part of treatment for certain types of pediatric cancer. It is important to realize that any risk of breast cancer after treatment with doxorubicin is low. If you are unsure about your child's treatment, you can discuss this with his/her doctor.

I got breast cancer and was previously treated for childhood cancer - is this because of the doxorubicin?

Getting breast cancer can have several causes. It may have nothing at all to do with pediatric cancer treatment. It may be due to radiation on the breast. Or, if you have had a high dose of anthracyclines, this could possibly be a cause. It is impossible to know the cause for sure. There are many different factors that can contribute to the development of breast cancer.

I am shocked by this news or worried about my own health after reading this story, what should I do now?

The fact that the increased risk of breast cancer due to doxorubicin has now been confirmed by research does not mean that everyone will develop the disease. This only applies to a small number of the people who received a high dose of doxorubicin. We also understand that the news can be distressing. Are you worried? Or do you have questions about your own individual situation? Please contact your treating physician or the LATER clinic. They are ready to answer your questions. Does this message bring up emotions that you want to share with someone? You can also contact the LATER clinic for this. Sometimes can also feel good to share your concerns with those around you or with other people who are (or have been in) the same situation.