A single-institution study of 2,329 women following BCT showed that a 6- month interval for surveillance detected a higher proportion of local recurrences at an earlier stage compared with annual surveillance [174]. In a single-institution study of 789 asymptomatic women after BCT, 1.2% had cancer diagnosed at the 6-month timepoint following treatment (n = 169), and 0.6% had cancer detected in women who Imaging of Invasive Breast Cancer underwent routine mammographic screening a year after treatment (n = 620) [175]. However, earlier diagnosis did not result in a difference in local and distant disease-free survival. In summary, there is insufficient evidence demonstrating superior outcomes with diagnostic versus screening mammography for breast cancer surveillance. Expert consensus is to perform an annual diagnostic examination for the first 3 years, followed by routine annual screening, due to the increased complexity of interpretation from postsurgical and postradiation changes [176] and the increased risk of recurrence in the first 3 years following treatment [177-180]. There have been multiple studies evaluating the performance of DM versus DBT for surveillance. Chikarmane et al [181] compared tomosynthesis with 2-D mammography in women with a personal history of breast cancer treated with lumpectomy and mastectomy. They reported a significant decrease in recall rate (7.9% versus 10.1%, respectively) and increased sensitivity (92.3% versus 90.0%, respectively) with tomosynthesis with no significant difference in the cancer detection rate (6.1 versus 6.0 per 1,000 women screened, respectively) or PPV (12.0% versus 6.4%, respectively). These changes in interpretive performance were similar regardless of whether the women underwent breast-conserving surgery or mastectomy. There is evidence that mammography alone may not be sufficient for surveillance in this population.
Imaging of Invasive Breast Cancer. A single-institution study of 2,329 women following BCT showed that a 6- month interval for surveillance detected a higher proportion of local recurrences at an earlier stage compared with annual surveillance [174]. In a single-institution study of 789 asymptomatic women after BCT, 1.2% had cancer diagnosed at the 6-month timepoint following treatment (n = 169), and 0.6% had cancer detected in women who Imaging of Invasive Breast Cancer underwent routine mammographic screening a year after treatment (n = 620) [175]. However, earlier diagnosis did not result in a difference in local and distant disease-free survival. In summary, there is insufficient evidence demonstrating superior outcomes with diagnostic versus screening mammography for breast cancer surveillance. Expert consensus is to perform an annual diagnostic examination for the first 3 years, followed by routine annual screening, due to the increased complexity of interpretation from postsurgical and postradiation changes [176] and the increased risk of recurrence in the first 3 years following treatment [177-180]. There have been multiple studies evaluating the performance of DM versus DBT for surveillance. Chikarmane et al [181] compared tomosynthesis with 2-D mammography in women with a personal history of breast cancer treated with lumpectomy and mastectomy. They reported a significant decrease in recall rate (7.9% versus 10.1%, respectively) and increased sensitivity (92.3% versus 90.0%, respectively) with tomosynthesis with no significant difference in the cancer detection rate (6.1 versus 6.0 per 1,000 women screened, respectively) or PPV (12.0% versus 6.4%, respectively). These changes in interpretive performance were similar regardless of whether the women underwent breast-conserving surgery or mastectomy. There is evidence that mammography alone may not be sufficient for surveillance in this population.