{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:19:36Z","timestamp":1780647576118,"version":"3.54.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1175","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020806","name":"ANR","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020806","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Investissements d\u2019Avenir"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Modern radiotherapy techniques have significantly reduced radiation exposure to healthy tissues. This study analysed breast tissue radiation doses in a national pediatric radiotherapy database, explored the discrepancy between prescribed and actual doses and analysed shortcomings of current breast screening guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed PediaRT database data on radiotherapy dose distributions for 5079 French childhood cancer patients (2013\u2013present), focusing on photon therapy plans with available breast dose data (n\u2009=\u2009428). Biological equivalent dose (BED) was calculated, and statistical analyses (t-tests, chi-square, Mann\u2013Whitney U, Fisher\u2019s exact, and logistic regression) identified factors associated with breast dose exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among patients receiving supra-diaphragmatic radiotherapy, 99.3% had a prescribed dose &amp;gt;10\u2009Gy, but 62.1% received a maximum dose greater than 10\u2009Gy to at least one breast, and 25.5% received a mean dose greater than 10\u2009Gy. As pediatric treatments often use fraction sizes &amp;lt;2\u2009Gy, BED analysis revealed that 51.29% to 80.47% of patients prescribed &amp;gt;10\u2009Gy received &amp;lt;10\u2009Gy as minimal, maximal, or mean dose. These discrepancies suggest that current breast cancer screening guidelines, based on prescribed doses, may overestimate risk in survivors treated with modern techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings support a shift toward dose-specific screening recommendations based on actual tissue exposure. Relying solely on prescribed doses and fields may lead to unnecessary screenings and increased burden for patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>This study is the first to assess actual breast tissue radiation doses using a national multicenter pediatric radiotherapy database. It highlights how current breast cancer screening guidelines based on prescribed doses may overestimate risk in survivors treated with modern radiotherapy techniques.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqaf131","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T15:54:19Z","timestamp":1752076459000},"page":"1977-1985","source":"Crossref","is-referenced-by-count":1,"title":["Long-term breast cancer risk post childhood cancer radiotherapy: data-driven screening recommendations for survivors"],"prefix":"10.1093","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1236-9089","authenticated-orcid":false,"given":"Charlotte","family":"Demoor-Goldschmidt","sequence":"first","affiliation":[{"name":"Pediatric Oncology Department, University Hospital of Angers , Angers, 49000,","place":["France"]},{"name":"Pediatric Oncology Department, University Hospital of Caen , Caen, 14000,","place":["France"]},{"name":"Inserm Unit 1018 , Gustave Roussy, Villejuif, 94800,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilde","family":"Lefresne","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department, University Hospital of Angers , Angers, 49000,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Jouglar","sequence":"additional","affiliation":[{"name":"Institut Curie, Radiation Oncology Departement, Paris & Proton Center , Orsay, 75005,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Ollivier","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Institut de Canc\u00e9rologie de l\u2019Ouest , Saint Herblain, 44800,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Bolle","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Gustave Roussy , Villejuif, 94800,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Alapetite","sequence":"additional","affiliation":[{"name":"Institut Curie, Radiation Oncology Departement, Paris & Proton Center , Orsay, 75005,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Truc","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Georges Fran\u00e7ois Leclerc Cancer Center , Dijon, 21000,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia","family":"Padovani","sequence":"additional","affiliation":[{"name":"INP, UMR7051 , Marseille, 13005,","place":["France"]},{"name":"Department of Radiotherapy, Assistance Publique H\u00f4pitaux de Marseille , Marseille, 13385,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0103-7935","authenticated-orcid":false,"given":"Anne","family":"Laprie","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Institut Universitaire du Cancer de Toulouse (IUCT) Oncopole Claudius Regaud , Toulouse, 31059,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Bernier-Chastagner","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, Institut de Canc\u00e9rologie de Lorraine , Vandoeuvre-les-Nancy, 54500,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"2025112712214306500_tqaf131-B1","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1200\/JCO.22.00574","article-title":"Health benefits and cost-effectiveness of children's oncology group 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