Time Intervals for Imaging Evaluation of Patients Following Breast-Conservation Surgery

• Previously, there was no consensus on the optimal time intervals for imaging evaluation of patients following breast-conservation surgery:
  • Many practices performed 6-month interval mammography of the treated breast for a variable number of years in an effort to monitor post-procedure changes

• The usefulness of short-term follow-up mammography in women undergoing breast conservation has been challenged:
  • Local recurrence in the ipsilateral breast following breast conservation and radiotherapy occurs at:
    • An estimated rate of:
      • 1% in the first year
      • 3% to 9% at 5 years
      • 14% to 20% at 20 years
  • Retrospective studies have verified that the yield from a 6-month follow-up mammogram on the affected side is:
    • Low (≤ 1%)
• Therefore, the ACR and ASCO recommendations are:
  • To perform a bilateral mammogram at 12 months from the initial mammogram:
    • Which should be at least 6 months following completion of radiotherapy:
      • And should include a diagnostic mammogram on the affected side and a screening mammogram on the nontreated side
  • Bilateral annual mammography is recommended thereafter
• Elimination of the 6-month and 18-month interval diagnostic mammograms after breast conservation:
  • Should spare women unnecessary anxiety, discomfort, and inconvenience while lowering costs and improving efficiency

• References:
  • https://www.asco.org/research-guidelines/quality-guidelines/guidelines/breast-cancer#/9821 Accessed July 20, 2020
  • Monticciolo DL, Newell MS, Moy L, Niell B, Monsees B, Sickles EA. Breast cancer screening in women at higher-than-average risk: recommendations from the ACR. J Am Coll Radiol. 2018;15(3 Pt A):408-414.
  • Khatcheressian JL, Hurley P, Bantug E, Esserman LJ, Grunfeld E, Halberg F, et al. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31(7):961-965.

#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #BreastCancer #intervalBreastImaging #CASO #CenterforAdvancedSurgicalOncology #PalmettoGeneralHospital