Annual Mammogram is Usually Enough
Many women are (unhappily) surprised by the minimal follow-up suggested after the completion of breast cancer treatment. After being diagnosed with such a serious illness and going through intense therapy, the assumption would be that regular and rigorous follow-up tests and appointments would be forthcoming. Wrong. Or, at least, usually wrong.
Most women are quite quickly transitioned to visits twice a year with their medical oncologist, and once or twice a year with both the radiation oncologist and surgeon. There are differences in practice, of course, and individual circumstances may dictate another schedule. It is also usually surprising to learn that few tests are ordered: an annual mammogram, perhaps an annual breast MRI (for high risk women, usually meaning women who are gene positive or have had more than one breast cancer or fit other specific criteria), are it. As I have discussed at other times, ASCO does not recommend regular blood tests for markers: (http://tinyurl.com/2c8flhz).
This leaves women wondering, at least, why more frequent mammograms are not suggested. This is a report from MedScape about a recent study confirming that annual exams are sufficient. Again, I give you an excerpt and a link:
Annual Mammography Adequate After Breast-
November 12, 2010 — There has been no shortage of debate concerning routine screening mammography in the general population, especially after last year's release of the US Preventive Services Task Force's new recommendations.
However, another aspect of mammography has not received nearly as much attention. What is the optimum timing and frequency of mammograms for patients after breast-conserving therapy?
According to data presented here at the American Society for Radiation Oncology 52nd Annual Meeting, there is no benefit associated with short-interval mammography after this procedure.
"Short-interval mammograms may provide a mammographer with baseline information, but short-term mammography after breast-conservation surgery has an extremely low yield for new ipsilateral invasive breast cancer," said study author William T. Sause, MD, a radiation oncologist at Intermountain Healthcare in Utah.
There would also be a significant cost savings by switching to an annual mammogram, as opposed to undergoing the procedure every 6 months. "Eliminating short-term mammography would result in a minimum direct cost savings of over a million dollars in this patient cohort, and that does not include ultrasound, repeat biopsies, magnetic resonance imaging, and all the downstream events that occur," he explained during his presentation.