The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer

Lu, Wenli; Schaapveld, Michael; Jansen, Liesbeth; Bagherzadegan, Emad; Sahinovic, Marko; Baas, Peter C.; Hanssen, Leo M.H.C.; Mijle, Hans C.J. van der; Brandenburg, Jan D.; Wiggers, Theo; Bock, Geertruida H. de

doi:10.1016/j.ejca.2009.08.007

Cited by 44 publications

(39 citation statements)

References 31 publications

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“…Although not formally tested, some studies suggest that in younger patients, with potentially more aggressive tumors, annual mammographies should be performed due to the higher risk of interval tumors, while in older patients, a biannual procedure could be done [2,21]. In very young patients or those with a genetic predisposition to breast cancer, a combined approach with MRI and mammography could be reasonable.…”

Section: Discussionmentioning

confidence: 95%

“…Of note, around half of the second cancers were diagnosed mammographically during routine follow-up. In this sense, contralateral surveillance mammography is recommended in the follow-up of patients treated for breast cancer and aims at early detection of MCBC to optimize the outcome [15], although the survival benefit of diagnosing MCBC by mammography has not yet been studied thoroughly [2,16]. However, observational studies do suggest that the Unknown progesterone receptors 2 (6.9%) 6 (20.7%) diagnosis of a secondary primary tumor detected before its symptomatic onset has a favorable impact on the survival of patients with MCBC [17].…”

Section: Discussionmentioning

confidence: 99%

“…Contralateral breast cancer is the most common second primary malignancy in patients with a previous history of breast cancer [1,2], and women diagnosed with their primary breast cancer have a two-to sixfold greater risk for contralateral breast cancer compared to women with the risk of a first breast cancer in the general population [3]. Improved survival of breast cancer patients, coupled with the increased incidence of the disease, has also placed more women at risk for the development of a second cancer in the contralateral breast [3,4].…”

Section: Discussionmentioning

confidence: 99%

“…Women with breast cancer have a three-to fourfold increased risk of developing a new primary cancer in the contralateral breast [1,2]. In effect, it is the most frequent cancer reported after primary breast cancer, comprising between 30 and 50% of all second cancers.…”

Section: Introductionmentioning

confidence: 99%

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Synchronous and metachronous bilateral breast cancer: a long-term single-institution experience

et al. 2010

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Bilateral breast cancer (bBC) is the most common 2nd tumor in primary BC patients. However, its natural history is poorly understood as is the effect of previous adjuvant therapies. Between 1980 and 2005, we identified 3757 BC patients treated in our Institution, with 120 (3.2%) cases of bBC, 91 (2.4%) were metachronous BC (mBC), 29 (0.8%) synchronous BC (sBC). sBC defined as found before 3 months of the initial diagnosis. We performed a descriptive and an overall survival (OS) analysis. mBC appeared in young patients with a strong family history of BC. Most were diagnosed mammographically. The risk did not disappear after 15 years of follow-up. In most estrogen receptor (ER)-positive cases, the 2nd tumor was also ER-positive (concordance rate of 91%). No differences were seen according to the previous use of tamoxifen. In ER-negative cases, 43% of mBC were ER-positive. Synchronous BC (sBC) appeared in an elderly population with a strong family history. About 76% were ER-positive. ER status concordance was seen in 62%. There were no statistically significant differences in OS between patients with sBC or those with the 2nd mBC. A shorter time to appearance of the 2nd tumor predicted a worse OS. ER negativity and grade 3 tumors were negative prognostic factors. The risk of mBC does not abate with the pass of time. Contralateral mammographies should form part of follow-up. ER status concordance is high, especially in ER-positive cases. No differences were seen according to previous use of tamoxifen. Shorter disease-free intervals were linked with worse OS.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Synchronous and metachronous bilateral breast cancer: a long-term single-institution experience

et al. 2010

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“…The place of mammography in the follow-up of young breast cancer survivors has not been examined. In older women, annual mammography is recommended for the detection of contralateral breast cancer [65][66][67]. Age of diagnosis of the first breast cancer and hereditary BRCA1, BRCA2, and ATM mutations are considered to be of the most important risk factors that predispose to contralateral breast cancer [68,69].…”

Section: Discussionmentioning

confidence: 99%

Time for a re-evaluation of mammography in the young? Results of an audit of mammography in women younger than 40 in a resource restricted environment

Taylor

Basro

Apffelstaedt

et al. 2011

Breast Cancer Res Treat

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Mammography in younger women is considered to be of limited value. In a resource restricted environment without access to magnetic resonance imaging (MRI) and with a high incidence of breast cancer in the young, mammography remains an important diagnostic tool. Recent technical advances and better regulation of mammography make a reassessment of its value in these conditions necessary. Data of all the mammograms performed at a tertiary hospital and private breast clinic between January 2003 and July 2009 in women less than 40 years of age were collected. Indications were the presence of a mass, follow-up after primary cancer therapy, and screening for patients perceived at high risk due to a family history or the presence of atypical hyperplasia. Data acquired were as follows: Demographics, prior breast surgery, indication for mammography, outcome of mammography, diagnostic procedures, and their results. Of 2,167 mammograms, 393 were performed for a palpable mass, diagnostic mammography. In these, the overall cancer detection rate was 40%. If the mammography was reported as breast imaging reporting and data system (BIRADS(®)) 5 versus BIRADS(®) 3 and 4 versus BIRADS(®) 1 and 2, a final diagnosis of malignancy was established in 96, 48, and 5%, respectively. Of 367 mammograms done for the follow-up after primary treatment of breast cancer, seven cancers were diagnosed for a detection rate of 1.9%. Of 1,312 mammograms performed for screening, the recall rate was 4%; the biopsy rate 2%, and the cancer diagnosis rate 3/1,000 examinations. In contrast to past series, this series has shown that recent advances in mammography have made it a useful tool in the management of breast problems in young women, notably in a resource-restricted environment. Women for screening should be selected carefully.

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Accuracy and Outcomes of Screening Mammography in Women With a Personal History of Early-Stage Breast Cancer

Houssami

Abraham

Miglioretti

et al. 2011

JAMA

146

106

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Context Women with a personal history of breast cancer (PHBC) are at risk of developing another breast cancer and are recommended for screening mammography. Few high-quality data exist on screening performance in PHBC women. Objective To examine the accuracy and outcomes of mammography screening in PHBC women relative to screening of similar women without PHBC. Design and Setting Cohort of PHBC women, mammogram matched to non-PHBC women, screened through facilities (1996–2007) affiliated with the Breast Cancer Surveillance Consortium. Participants There were 58 870 screening mammograms in 19 078 women with a history of early-stage (in situ or stage I-II invasive) breast cancer and 58 870 matched (breast density, age group, mammography year, and registry) screening mammograms in 55 315 non-PHBC women. Main Outcome Measures Mammography accuracy based on final assessment, cancer detection rate, interval cancer rate, and stage at diagnosis. Results Within 1 year after screening, 655 cancers were observed in PHBC women (499 invasive, 156 in situ) and 342 cancers (285 invasive, 57 in situ) in non-PHBC women. Screening accuracy and outcomes in PHBC relative to non-PHBC women were cancer rates of 10.5 per 1000 screens (95%CI, 9.7–11.3) vs 5.8 per 1000 screens (95%CI, 5.2–6.4), cancer detection rate of 6.8 per 1000 screens (95%CI, 6.2–7.5) vs 4.4 per 1000 screens (95% CI, 3.9–5.0), interval cancer rate of 3.6 per 1000 screens (95%CI, 3.2–4.1) vs 1.4 per 1000 screens (95% CI, 1.1–1.7), sensitivity 65.4% (95% CI, 61.5%–69.0%) vs 76.5% (95% CI, 71.7%–80.7%), specificity 98.3% (95% CI, 98.2%–98.4%) vs 99.0% (95% CI, 98.9%–99.1%), abnormal mammogram results in 2.3% (95% CI, 2.2%–2.5%) vs 1.4% (95% CI, 1.3%–1.5%) (all comparisons P <.001). Screening sensitivity in PHBC women was higher for detection of in situ cancer (78.7%;95% CI, 71.4%–84.5%) than invasive cancer (61.1%; 95% CI, 56.6%–65.4%), P<.001; lower in the initial 5 years (60.2%; 95% CI, 54.7%–65.5%) than after 5 years from first cancer (70.8%;95% CI, 65.4%–75.6%), P =.006; and was similar for detection of ipsilateral cancer (66.3%; 95% CI, 60.3%–71.8%) and contralateral cancer (66.1%; 95% CI, 60.9%–70.9%), P=.96. Screen-detected and interval cancers in women with and without PHBC were predominantly early stage. Conclusion Mammography screening in PHBC women detects early-stage second breast cancers but has lower sensitivity and higher interval cancer rate, despite more evaluation and higher underlying cancer rate, relative to that in non-PHBC women.

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The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer

Cited by 44 publications

References 31 publications

Synchronous and metachronous bilateral breast cancer: a long-term single-institution experience

Synchronous and metachronous bilateral breast cancer: a long-term single-institution experience

Time for a re-evaluation of mammography in the young? Results of an audit of mammography in women younger than 40 in a resource restricted environment

Accuracy and Outcomes of Screening Mammography in Women With a Personal History of Early-Stage Breast Cancer

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