Digital Breast Tomosynthesis Diagnostic Annual mammography is the best imaging test for surveillance in this clinical scenario, with reduction of mortality compared with women with history of breast cancer who do not get annual mammography [40,41]. The most common presentation of a recurrent or second breast cancer in patients with a personal history of breast cancer is an abnormal mammogram in an otherwise asymptomatic patient [22,34,36]. This ACR practice parameter allows asymptomatic women with a personal history of breast cancer to undergo diagnostic mammography [42]. A survey of radiologists showed variability in recommendation of diagnostic versus screening mammography for women treated with breast conservation therapy. Most (79%) recommended at least 1 diagnostic mammogram, with 49% recommending diagnostic mammography up to 2 years and 33% recommending diagnostic mammography from 2 to 5 years [43]. This is supported by the fact that most locoregional recurrences occur within 5 years after diagnosis [34,35,44], with recurrence risk greatest 2 to 3 years after initial therapy [23,28,33,37]. There is suboptimal compliance of annual mammography in select patients with a history of breast cancer. Groups most impacted are younger women <45 to 50 years of age, older women >65 years of age, African Americans and other underrepresented minorities, and women who did not have a recent physician visit [34,45-50]. The American Society of Radiology Oncology (ASTRO) and National Comprehensive Cancer Network (NCCN) both recommend annual mammographic surveillance for women who have completed radiation therapy as part of breast conservation therapy, with the first imaging performed at 6 to 12 months [51,52]. Other studies have found imaging before 12 months is not beneficial and/or leads to unnecessary additional imaging because of acute breast changes, supporting the first mammogram to be at 12 months after the last mammogram [30,53-56].
Imaging after Breast Surgery. Digital Breast Tomosynthesis Diagnostic Annual mammography is the best imaging test for surveillance in this clinical scenario, with reduction of mortality compared with women with history of breast cancer who do not get annual mammography [40,41]. The most common presentation of a recurrent or second breast cancer in patients with a personal history of breast cancer is an abnormal mammogram in an otherwise asymptomatic patient [22,34,36]. This ACR practice parameter allows asymptomatic women with a personal history of breast cancer to undergo diagnostic mammography [42]. A survey of radiologists showed variability in recommendation of diagnostic versus screening mammography for women treated with breast conservation therapy. Most (79%) recommended at least 1 diagnostic mammogram, with 49% recommending diagnostic mammography up to 2 years and 33% recommending diagnostic mammography from 2 to 5 years [43]. This is supported by the fact that most locoregional recurrences occur within 5 years after diagnosis [34,35,44], with recurrence risk greatest 2 to 3 years after initial therapy [23,28,33,37]. There is suboptimal compliance of annual mammography in select patients with a history of breast cancer. Groups most impacted are younger women <45 to 50 years of age, older women >65 years of age, African Americans and other underrepresented minorities, and women who did not have a recent physician visit [34,45-50]. The American Society of Radiology Oncology (ASTRO) and National Comprehensive Cancer Network (NCCN) both recommend annual mammographic surveillance for women who have completed radiation therapy as part of breast conservation therapy, with the first imaging performed at 6 to 12 months [51,52]. Other studies have found imaging before 12 months is not beneficial and/or leads to unnecessary additional imaging because of acute breast changes, supporting the first mammogram to be at 12 months after the last mammogram [30,53-56].