Evidence-based recommendation for subsequent breast cancer (IGHGa)

This page is part of the PanCare follow-up recommendations for surveillance of late effects. Click here, for more information on these recommendations.

Who is at risk for subsequent breast cancer?

Female CAYA cancer survivors treated with

  • radiotherapy ≥ 10 Gy to a volume exposing the breasts
  • high abdominal field radiation above the diaphragm at a young age b

What surveillance modality should be used and at what frequency should it be performed?

  • A physical examination of the breasts c
  • A mammography
  • A breast MRI
    every year in survivors ≥ 25 years of age or ≥ 8 years from radiation, whichever occurs last

What should be done if abnormalities are identified?

  • Refer to the appropriate HCP


While PanCare strives to provide accurate and complete information that is up-to-date as of the date of publication, we acknowledge that the sequence of referral and diagnostic tests might vary according to the local and national healthcare system logistics.

It is recognised that survivors and their healthcare professionals have the final responsibility for making decisions concerning their long-term follow-up care. As such, they may choose to either adopt these recommendations or not to do so after individual informed discussion. It is good practice to document this decision.

In addition to regular surveillance, real-time awareness and prompt reporting of new symptoms and signs is essential to the early detection and timely treatment of late effects.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

a This recommendation reflects the recommendations of the preliminary updated evidence-based IGHG breast cancer guideline. The guideline will be published in a peer-reviewed journal soon.

b For survivors treated with high abdominal field radiation above the diaphragm at a young age the surveillance decision should be an individual one, taking into account additional risk factors (patient age, family history, menopausal status, other previous cancer treatment) and personal values regarding the potential advantages and disadvantages of surveillance (see Survivor Information Form).

c Clinical breast exam for female survivors at risk who are returning for follow-up medical evaluations in countries where breast cancer surveillance access is through clinical referral.