Choosing Wisely:

Don’t routinely recommend follow-up mammograms more often than annually for women who have had radiotherapy following breast conserving surgery.

Rationale and Comments: Studies indicate that annual mammograms are the appropriate frequency for surveillance of breast cancer patients who have had breast conserving surgery and radiation therapy with no clear advantage to shorter interval imaging. Patients should wait 6-12 months after the completion of radiation therapy to begin their annual mammogram surveillance. Suspicious findings on physical examination or surveillance imaging might warrant a shorter interval between mammograms.
Sponsoring Organizations:
  • American Society for Radiation Oncology
  • Sources:
  • American Society of Clinical Oncology guideline
  • Cochrane Database of Systematic Reviews
  • Disciplines:
  • Oncologic
  • Women's health
  • References: • Khatcheressian JL. Breast cancer follow-up and management after primary treatment: an American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2013 Mar 1;31(7):961–5.
    • Grunfeld E. Cancer practice guidelines for the care and treatment of breast cancer: follow-up after treatment for breast cancer (summary of the 2005 update). CMAJ. 2005 May 10;172(10):1319–20.
    • Gradishar WJ. NCCN Clinical Practice Guidelines in Oncology. Breast Cancer. Version 3.2014.
    • Rojas MP. Follow-up strategies for women treated with early breast cancer. Cochrane Database Syst Rev. 2005;1:CD001768.
    • McNaul D, Darke M, Garg M, Dale P. An evaluation of post-lumpectomy recurrence rates: is follow-up every 6 months for 2 years needed? J Surg Oncol. 2013;107(6):597–601.

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