Study: Interval mammo unnecessary after BCT

Annual mammograms provide the same outcomes as interval mammograms at lower healthcare costs for women undergoing follow-up for breast conserving therapy (BCT), according to a study presented April 29 at the Cancer Imaging and Radiation Therapy Symposium in Atlanta, co-sponsored by the American Society for Radiation Oncology (ASTRO) and Radiological Society of North America (RSNA).

Although mammography is the standard follow-up for women after BCT, there is no clear consensus on how often the study should be repeated in this population.

The protocol at Abington Memorial Hospital in Abington, Pa., is somewhat ambiguous, according to Scott Herbert, MD, clinical associate professor of radiation oncology at Drexel University in Philadelphia.

At the initial follow-up mammogram one year after BCT, radiologists often notice post-treatment changes—which should be expected after surgery and radiation. Nevertheless, some radiologists recommend interval mammograms six months after the first follow-up mammogram.

To determine the clinical relevance and utility of an interval mammogram after BCT, Herbert and colleagues reviewed the records of 467 BCT patients followed up at Abington Memorial Hospital between 2007 and 2010.

For the trial, 87 out of 467 BCT patients underwent an interval mammogram, which led to four biopsies that yielded no recurring or new breast cancers. Fifty-six patients were recommended to return to yearly follow-up mammogram after clinical evaluation, and 27 women with questionable findings on the interval mammogram underwent ultrasound or MRI.

However, none of the patients had any malignancy identified after the interval mammogram. “Based on these results it was our feeling that the interval mammogram is an unnecessary procedure,” affirmed Herbert. In addition, researchers determined that eliminating the interval mammogram would result in lower healthcare costs.

"I think this will prompt physicians to reconsider the recommendation for an interval mammogram, which will ultimately save the medical community and the patients money, in addition to decreasing patient stress and minimizing unnecessary biopsies."

 

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