When to Get Imaging Studies of the Breast after Breast Conserving Surgery?

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • 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:
      • It 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 #MountSinaiMedicalCenter
Unknown's avatar

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.

Leave a comment