The most appropriate posttherapy breast imaging surveillance after Breast Conservation Surgery is?

Rodrigo Arrangoiz MS, MD, FACS, FSSO
👉Women with a personal history of breast cancer are at an elevated lifetime risk of developing an ipsilateral breast tumor recurrence (IBTR) or a new primary cancer in the contralateral breast.
👉Women with early-stage invasive breast cancer treated with breast-conserving therapy are reported to develop IBTR at a rate of approximately 0.5 to 1.0%/year.
👉There are no randomized controlled trials reporting the accuracy or impact on breast cancer mortality of mammographic surveillance following breast cancer treatment.
👉The sensitivity of screening mammography to detect IBTR ranges from 50% to 80% and to detect contralateral breast cancer, from 45% to 90%.
👉Surveillance for breast cancer survivors is not a generally recognized indication for breast MRI.
👉In fact, the most recent 2012 American Society of Clinical Oncology (ASCO) Guidelines advise against breast MRI for routine breast cancer surveillance:

  • Instead advocate that the first postlumpectomy mammogram be done at least 6 months after completing radiation therapy, with subsequent mammograms obtained yearly thereafter.
  • Current National Comprehensive Cancer Network guidelines mirror the ASCO guidelines. 

REFERENCES

  1. Houssami N, Ciatto S. Mammographic surveillance in women with a personal history of breast cancer: how accurate? how effective? Breast. 2010;19:439-445.
  2. Khatcheressian JL, Hurley P, Bantug E, et al; American Society of Clinical Oncology. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:961-965.
  3. Turnbull L, Brown S, Harvey I, et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial. Lancet. 2010;375:563-571.

👉Rodrigo Arrangoiz MS, MD, FACS cirujano oncology y cirujano de mamá de Sociedad Quirúrgica S.C en el America British Cowdray Medical Center en la ciudad de Mexico:

  • Es experto en el manejo del cáncer de mama.

 

👉Es miembro de la American Society of Breast Surgeons:

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

 

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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