Surveillance mammography after breast conservation therapy in Hong Kong: effectiveness and feasibility of risk-adapted approach

Breast. 2008 Apr;17(2):132-7. doi: 10.1016/j.breast.2007.08.001. Epub 2007 Oct 1.

Abstract

Annual surveillance mammography is commonly recommended after breast conservation therapy (BCT). We retrospectively reviewed its effectiveness on 511 invasive and non-invasive breast cancers treated with BCT between 1994 and 2003. The median follow-up was 5.9 years. The 5-year actuarial ipsilateral breast tumour recurrence (IBTR) rate was 4.5% and contralateral breast cancer (CBC) rate was 2.0% (representing eight times increase in risk). IBTR of 43% and 62% CBC were first detected by surveillance mammography. The IBTR detection rates per 1000 mammograms were 5.2 for patients (n=349) with one or more IBTR risk factors (age 45, positive/close margins or histological grade 3) and 0.6 for patients (n=162) without. No survival difference was observed between different modes of IBTR detection (p=0.342). In conclusion, a risk-adapted approach of limiting ipsilateral surveillance to patients with IBTR risk is possible but its implementation will be complicated by the continued need of contralateral surveillance.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / surgery*
  • Cost-Benefit Analysis
  • Feasibility Studies
  • Female
  • Hong Kong
  • Humans
  • Mammography / economics*
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Survival Analysis
  • Survival Rate
  • Treatment Outcome