Monitoring

Regular physical exams and annual mammography are as effective as more intensive monitoring following completion of primary treatment.[476] [ Cochrane Clinical Answers logo ]

Regular and thorough history, physical exam, and mammography should be the mainstay of long-term surveillance of breast cancer.[116][424]​​​ Early detection of isolated recurrences in patients without symptoms may improve survival of breast cancer patients.[477] All patients should undergo a detailed history and physical exam by a physician who is experienced in the surveillance of cancer patients and in breast examinations.

Intervals between exams should be 4-6 months for the first 5 years and yearly thereafter.[116]

Annual mammographic surveillance is recommended for women who have had breast-conserving therapy. Annual mammograms should not start until 6-12 months after completion of radiation therapy.​[116][478]​​​​​

The clinical utility of breast MRI surveillance in women with a personal history of breast cancer is dependent upon risk factors identified in studied populations, in addition to institutional protocols.[479]

Whole-breast ultrasound, using handheld or automated technique, may be used as a supplemental screening examination for women who are at high risk for developing secondary breast cancer.[68]​​[479]​​​​​​​

Following mastectomy (with or without reconstruction [autologous or nonautologous]), imaging on the side of the mastectomy is not typically recommended for surveillance.[480] Breast ultrasound is usually appropriate to evaluate a woman with a palpable lump or clinically significant pain on the side of the mastectomy.[480]​​

The use of other laboratory tests (including tumor markers) and further body imaging is not recommended, unless clinically indicated.[116]

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