# Breast screening after chest radiotherapy at a young age

Source: https://onco.cc/protocols/breast-screening-after-chest-radiotherapy-at-a-young-age/  
OnCo record `breast-screening-after-chest-radiotherapy-at-a-young-age` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Women who had radiotherapy to the chest as children, teenagers or young adults, for example for Hodgkin lymphoma, have a much higher chance of breast cancer at a young age. They should be offered yearly breast MRI and mammograms, starting at 25 or 30 or 8 years after the radiotherapy, whichever is later. In England this is arranged through the NHS very high risk screening programme.

## Summary

Female survivors of childhood, adolescent and young adult cancer treated with chest radiotherapy of 10 Gy or more have a cumulative breast cancer incidence of 13 to 20 per cent by 40 to 45 years, and up to 35 per cent by 50 (IGHG 2020). IGHG recommends annual mammography and breast MRI from age 25 or 8 years after radiotherapy, whichever is later, up to at least age 60 (level A, strong), and annual surveillance from 25 to be reasonable after upper abdominal radiotherapy exposing breast tissue at a young age (level B, moderate). Surveillance should come with counselling on its benefits and harms.

In England the NHS Breast Screening Programme very high risk service takes women irradiated to breast tissue between 10 and 35 years of age, identified for lymphoma by the BARD dataset or referred by oncologists: annual MRI from 25 (irradiated at 10 to under 20) or 30 (irradiated at 20 to under 36), or 8 years after radiotherapy if later; annual MRI with mammography from 40 to under 51; annual mammography with or without MRI from 51 to under 71. Girls irradiated below 10 are not tested by the programme, unlike IGHG. For anthracyclines without chest radiotherapy, IGHG's 2026 update considers surveillance reasonable after 200 mg/m² of doxorubicin or more, from 30 or 8 years after exposure.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: breast cancer surveillance after Hodgkin lymphoma; breast MRI after mantle radiotherapy; very high risk breast screening after radiotherapy; IGHG breast surveillance; BARD referral
- Tags: protocol; survivorship; late-effects; screening

## Connected records

- drugs: [Doxorubicin](https://onco.cc/drugs/doxorubicin/)
- cancers: [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Mammography & tomosynthesis](https://onco.cc/technologies/mammography/)
- terms: [After Hodgkin lymphoma: the late effects, and the screening that follows them](https://onco.cc/terms/lymphoma-living-hodgkin-survivorship-screening/), [Late effects and survivorship toxicity](https://onco.cc/terms/late-effects/), [Late effects of Hodgkin lymphoma treatment, and the follow-up that answers them](https://onco.cc/terms/lymphoma-tx-hodgkin-late-effects/)

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