Table 3. Harmonized recommendations for breast cancer surveillance for female childhood, adolescent and young adult cancer survivors treated with chest radiation prior to age 30 years^*.

Who needs breast cancer surveillance?

Providers and female childhood, adolescent and young adult cancer survivors treated with chest radiation should be aware of breast cancer risk.

Breast cancer surveillance is recommended for female childhood, adolescent and young adult cancer survivors treated with ≥20 Gy chest radiation.

Breast cancer surveillance is reasonable for female childhood, adolescent and young adult cancer survivors treated with 10-19 Gy chest radiation based on clinical judgment and considering additional risk factors.

Breast cancer surveillance may be reasonable for female childhood, adolescent and young adult cancer survivors treated with 1-9 Gy chest radiation based on clinical judgment and considering additional risk factors.

At what age should breast cancer surveillance be initiated?

Initiation of breast cancer surveillance is recommended at age 25 years or ≥8 years from radiation (whichever occurs last) for female childhood, adolescent and young adult cancer survivors treated with ≥20 Gy chest radiation.

Initiation of breast cancer surveillance is reasonable at age 25 years or ≥8 years from radiation (whichever occurs last) for female childhood, adolescent and young adult cancer survivors treated with 10-19 Gy chest radiation.

Initiation of breast cancer surveillance may be reasonable at age 25 years or ≥8 years from radiation (whichever occurs last) for female childhood, adolescent and young adult cancer survivors treated with 1-9 Gy chest radiation.

At what frequency should breast cancer surveillance be performed?

Annual breast cancer surveillance is recommended for female childhood, adolescent and young adult cancer survivors treated with ≥20 Gy chest radiation for at least up to 50 years of age.

Annual breast cancer surveillance is reasonable for female childhood, adolescent and young adult cancer survivors treated with 10-19 Gy chest radiation for at least up to 50 years of age.

Annual breast cancer surveillance may be reasonable for female childhood, adolescent and young adult cancer survivors treated with 1-9 Gy chest radiation for at least up to 50 years of age.

At what age should breast cancer surveillance be stopped?

Annual breast cancer surveillance in female childhood, adolescent and young adult cancer survivors older than age 50 is reasonable based upon clinical judgment and pending availability of further data.

What surveillance modality should be used?

Mammography or breast MRI or a combination of mammography and breast MRI is recommended for female childhood, adolescent and young adult cancer survivors treated with chest radiation. The evidence is insufficient to recommend the ideal imaging modality.

Clinical breast exam may be reasonable for female childhood, adolescent and young adult cancer survivors treated with chest radiation returning for follow-up medical evaluations in countries where breast cancer surveillance access is through clinical referral.

Green, class I = strong recommendations to do; yellow, class IIa = moderate recommendation to do; orange, class IIb = weak recommendation to do.

Note: Breast cancer surveillance recommendations for female childhood, adolescent and young adult cancer survivors with a genetic predisposition to breast cancer are outside the scope of this paper. For that purpose, we refer to the country-specific recommendations.

Table 3. Harmonized recommendations for breast cancer surveillance for female childhood, adolescent and young adult cancer survivors treated with chest radiation prior to age 30 years*.

Table 3. Harmonized recommendations for breast cancer surveillance for female childhood, adolescent and young adult cancer survivors treated with chest radiation prior to age 30 years^*.