Follow-up Imaging Is Lacking for Many After Breast Cancer Surgery

Surgery resident Taiwo Adesoye, MD, MPH, from the University of Wisconsin, Madison, presented a study by National Cancer Database, at the American College of Surgeons Clinical Congress 2016. The study revealed that about one-third of US women who receive surgical treatment for breast cancer are not receiving appropriate follow-up.

• What the guidelines say: American Cancer Society and the National Comprehensive Cancer Network recommend mammography 6 to 12 months after completion of radiation therapy for breast cancer and annual mammography thereafter, for early detection of in-breast recurrences or new primary breast tumors.
• Reports reveal the contrary: Data analysis shows that only two-thirds of women diagnosed with stage II or III breast cancer receive breast imaging in the first follow-up year after surgery, and nearly two thirds are not receiving annual imaging for the next 4 years.

“The thing that’s different about this in terms of underutilization is that rates didn’t vary based on institution type. Often variation in utilization varies from local hospital to hospital based on local practice patterns. Here, it seems to be consistent across hospital types.” states principal investigator Caprice C. Greenberg, MD, professor of surgery at the University of Wisconsin.

• What is needed: Sarah Blair, MD, vice chair of academic affairs, Department of Surgery, and professor of surgery at the University of California, San Diego says, “Make sure patients have a good survivorship plan when they finish active treatment to make sure if they move or change insurance they know they should be doing mammograms once a year.”

Some doctors believe that follow ups may get neglected in women with multiple conditions because they have a lot going on, and in their short follow-up appointments, they get caught up with all other issues and forget the preventive measures.