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 screening 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 ASTRO and NCCN guidelines 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 due to acute breast changes, supporting the first mammogram to be at 12 months after the last mammogram [30,53-56]. Imaging after Breast Surgery More frequent imaging of the ipsilateral affected breast beyond annual surveillance mammography, at 6-month intervals for the first 2 to 5 years, has also been studied. Two groups showed no benefits to this more frequent imaging [30,56]. One study found lower stage of recurrence in women undergoing 6-month surveillance compared to annual surveillance; however, this may be secondary to decreased compliance with imaging recommendations in the annual surveillance group and follow-up was insufficient to assess for any mortality differences [57]. The addition of DBT to 2-D digital mammography or 2-D synthetic images in the surveillance of patients with prior breast cancer history has been shown to reduce recall rates and indeterminate findings [58-61], without significant change in cancer detection rate [60,61]. FDG-PET Breast Dedicated There is no relevant literature to support the use of FDG-PET breast in this clinical scenario.
Imaging after Breast Surgery. 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 screening 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 ASTRO and NCCN guidelines 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 due to acute breast changes, supporting the first mammogram to be at 12 months after the last mammogram [30,53-56]. Imaging after Breast Surgery More frequent imaging of the ipsilateral affected breast beyond annual surveillance mammography, at 6-month intervals for the first 2 to 5 years, has also been studied. Two groups showed no benefits to this more frequent imaging [30,56]. One study found lower stage of recurrence in women undergoing 6-month surveillance compared to annual surveillance; however, this may be secondary to decreased compliance with imaging recommendations in the annual surveillance group and follow-up was insufficient to assess for any mortality differences [57]. The addition of DBT to 2-D digital mammography or 2-D synthetic images in the surveillance of patients with prior breast cancer history has been shown to reduce recall rates and indeterminate findings [58-61], without significant change in cancer detection rate [60,61]. FDG-PET Breast Dedicated There is no relevant literature to support the use of FDG-PET breast in this clinical scenario.