Utility of annual surveillance mammography in patients with treated breast cancer -a single institutional experience from India

Abstract

Author(s): Avaronnan Manuprasad, Sreelakshmi Soman, Praveen Kumar Shenoy, Satheesh Babu T V* and Geetha Muttath

Introduction: Surveillance mammography is an integral component of survivorship care in breast cancer as they are at higher risk of developing “Second cancers”. This study aimed to find out the number of cases of second breast cancer (ipsilateral recurrence or contralateral primary breast cancer) detected through Annual Surveillance Mammography (ASM) in patients who were treated for primary breast cancer in a tertiary cancer centre in South India.

Methods: This was a retrospective study and the case records of all treated patients of breast cancer who underwent ASM from January 2019 to March 2019 were reviewed. Baseline characteristics, treatment details, and mammogram findings were recorded and analysed.

Results: Among the 203 patients included, 126 (62%) were post-menopausal. The median age was 53.5 years (30 years-74 years). The most common stage at presentation was Stage 2 (n=122,62%) followed by Stage 3 (n=54,27%) Most of the patients underwent Modified Radical Mastectomy (MRM) (84%). Most of the patients had BIRADS 1 status (n=192,93%) followed by BIRADS 2 (n=20,10%) BIRADS 4 (n=2,1%) and BIRADS 3 (n=1,0.5%). Two patients had BIRADS 4a lesion which were biopsied (1%) but showed no evidence of malignancy. The same patient group underwent a total of 503 mammograms prior to the current mammogram among which 6 mammograms were abnormal (1.1%). All the patients with abnormal mammograms underwent biopsy and one patient had invasive malignancy (0.2%).

Conclusion: Our results show that the pickup rate of ASM is lower compared to what is reported in the literature. We need larger studies to quantify the benefit of surveillance mammography and to define the optimal timing of initiation, frequency, and the need for individualized strategy.

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