Screening mammography after breast cancer treatment: patterns in community practice

Abstract

Background: Guidelines for screening women post-breast cancer treatment are generally lacking. This study was conducted to review the literature on guidelines for this population and to evaluate whether there is a common practice in the community for following these women.

Methods: The literature was reviewed for presence of published or inferred guidelines. Data were then used from the Carolina Mammography Registry (CMR) to see if patterns exist in community practice. For the years 1995-1999, 3081 women with a new diagnosis of unilateral breast cancer and a post-treatment screening mammogram in CMR were included. Recommendations for initial mammographic examination and intervals of subsequent mammograms post-treatment were described and tested for patterns of follow-up time.

Results: The only evidence-based guidelines found for post-treatment mammographic examinations were from the American Society of Clinical Oncology. They recommend 6 month follow-up initially followed by 12 month follow-up if findings remain stable. Among the 3081 women included in the study, 17.4% were recommended to return at 6 months post-treatment following their initial mammogram. Of the women who had at least three post-cancer mammograms (1592/3081), 82.6% were recommended for 12 month intervals at all three visits; only 2.1% of women were recommended for 6 month intervals at all three visits.

Conclusions: This study found that most community-based radiologists included in our study recommend following women at 12 month intervals post-treatment. Whether this 12 month screening interval is optimal for detecting recurrent cancers is not known and should be the focus of future research.