Assessing the impact of frequent mammography after breast cancer treatment from a single-institution retrospective analysis

Abstract

Background Despite prior attempts to establish guidelines, many radiologists still recommend frequent (every six month) mammography after breast conserving surgery. Ideally this recommendation would be based on the incremental value (recurrences detected earlier) of non-annual screening, compared to the associated harm (from false positive results leading to patient distress, unnecessary biopsies/procedures and costs). The aim of this study was to analyze the outcomes of performing biannual mammograms at our institution in order to determine if this may provide any additional benefit to annual mammograms. Methods A retrospective analysis of 359 female patients with stage 0-III breast cancer who underwent breast-conservation surgery was performed. Data were obtained on breast cancer characteristics, imaging, pathology, and recurrence rates. Descriptive analyses were subsequently performed. Results A total of 569 6-month and 18-month mammograms were completed after breast-conservation therapy. This led to 22 biopsies, only one of which detected a recurrence (in a high-risk patient who was unable to complete recommended treatment). Conclusions The data suggest that annual surveillance mammography following breast conserving therapy (BCT) is likely sufficient for detection of recurrences, with increased screening leading to increased harm without benefit. More frequent screening should be limited to select high-risk patients.