Promoting Breast Cancer Screening in Women Who Survived Childhood Cancer

• Principal Investigator: Kevin Oeffinger, MD
• Co-Principal Investigator: Jennifer Ford, PhD

The Problem

By age 50, almost one in three women, treated with chest radiation for childhood cancer, will be diagnosed with breast cancer. Early detection of breast cancer is strongly associated with survival, and surveillance with annual breast MRI and mammography is recommended, starting at age 25. Unfortunately, the vast majority of these women are not adherent to the recommended surveillance. Magnifying this problem, most childhood cancer survivors are no longer followed at a cancer center, are unaware of their risks, and are being followed by primary care providers (PCPs) who are not informed about the recommended follow-up care.

The Solution

Based upon our prior findings in EMPOWER-I, we proposed EMPOWER-II, a 3-arm randomized controlled trial that extends the core component of the EMPOWER-I intervention (mailed educational materials) to evaluate the utility of patient activation with and without added PCP activation to increase breast cancer surveillance.

This study was conducted through the Childhood Cancer Survivor Study (CCSS), which is coordinated through St. Jude Children’s Hospital.

We randomized 291 women, who are at least 25 years of age, with a history of chest radiation for childhood cancer, without a history of breast cancer, and without both a breast MRI and mammogram in the previous two years.

Impact

The EMPOWER-II study brings together a research team with the necessary expertise and experience in both survivorship research, smart-phone delivered interventions, and the unique resource of the 31-institution CCSS. Notably, the CCSS represents the single largest cohort of women in the target population and the infrastructure to conduct the proposed study.

EMPOWER-II study enrollment is now complete. Our team is working on analyzing the data collected. For preliminary results, visit ClinicalTrials.gov.