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. 2016 Dec;121(12):891-896.
doi: 10.1007/s11547-016-0676-8. Epub 2016 Sep 6.

Recommendations for breast imaging follow-up of women with a previous history of breast cancer: position paper from the Italian Group for Mammography Screening (GISMa) and the Italian College of Breast Radiologists (ICBR) by SIRM

Lauro Bucchi  1 , Paolo Belli  2 , Eva Benelli  3 , Daniela Bernardi  4 , Beniamino Brancato  5 , Massimo Calabrese  6 , Luca A Carbonaro  7 , Francesca Caumo  8 , Beatrice Cavallo-Marincola  9 , Paola Clauser  10   11 , Chiara Fedato  12 , Alfonso Frigerio  13 , Vania Galli  14 , Livia Giordano  15 , Paola Golinelli  16 , Giovanna Mariscotti  17 , Laura Martincich  18 , Stefania Montemezzi  19 , Doralba Morrone  5 , Carlo Naldoni  20 , Adriana Paduos  15 , Pietro Panizza  21 , Federica Pediconi  9 , Fiammetta Querci  22 , Antonio Rizzo  23 , Gianni Saguatti  24 , Alberto Tagliafico  25 , Rubina M Trimboli  7 , Chiara Zuiani  11 , Francesco Sardanelli  26   27
Affiliations

Recommendations for breast imaging follow-up of women with a previous history of breast cancer: position paper from the Italian Group for Mammography Screening (GISMa) and the Italian College of Breast Radiologists (ICBR) by SIRM

Lauro Bucchi et al. Radiol Med. 2016 Dec.

Abstract

Women who were previously treated for breast cancer (BC) are an important particular subgroup of women at intermediate BC risk. Their breast follow-up should be planned taking in consideration a 1.0-1.5 % annual rate of loco-regional recurrences and new ipsilateral or contralateral BCs during 15-20 years, and be based on a regional/district invitation system. This activity should be carried out by a Department of Radiology integrating screening and diagnostics in the context of a Breast Unit. We recommend the adoption of protocols dedicated to women previously treated for BC, with a clear definition of responsibilities, methods for invitation, site(s) of visits, methods for clinical and radiological evaluation, follow-up duration, role and function of family doctors and specialists. These women will be invited to get a mammogram in dedicated sessions starting from the year after the end of treatment. The planned follow-up duration will be at least 10 years and will be defined on the basis of patient's age and preferences, taking into consideration organizational matters. Special agreements can be defined in the case of women who have their follow-up planned at other qualified centers. Dedicated screening sessions should include: evaluation of familial/personal history (if previously not done) for identifying high-risk conditions which could indicate a different screening strategy; immediate evaluation of mammograms by one or, when possible, two breast radiologists with possible addition of supplemental mammographic views, digital breast tomosynthesis, clinical breast examination, breast ultrasound; and prompt planning of possible further workup. Results of these screening sessions should be set apart from those of general female population screening and presented in dedicated reports. The following research issues are suggested: further risk stratification and effectiveness of follow-up protocols differentiated also for BC pathologic subtype and molecular classification, and evaluation of different models of survivorship care, also in terms of cost-effectiveness.

Keywords: Breast cancer; Follow-up; Mammography; Screening; Survivorship care.

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Conflict of interest statement

The authors declare no funding and no conflict of interest for this article. Ethical standards This article does not contain any studies with human participants or animals performed by any of the authors.

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