Defining the Need for Imaging and Biopsy After Mastectomy
Soojin Ahn1, Brandon Elnekaveh1, Hank Schmidt1
1Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA.
Annals of Surgical Oncology
|September 12, 2018
Summary
Many patients choose mastectomy to avoid future breast imaging and biopsies. However, 10-15.5% require follow-up imaging and 6-8% need biopsies, with a low malignancy yield of about 1%.
Area of Science:
- Oncology
- Radiology
- Surgical Oncology
Background:
- Increasing trend of mastectomy over breast-conservation therapy (BCT).
- Patient preference for mastectomy driven by desire to eliminate future breast screening and biopsy.
- Need to investigate post-mastectomy imaging and biopsy incidence.
Purpose of the Study:
- To determine the incidence of post-mastectomy imaging and biopsy.
- To assess the diagnostic yield of malignancy in post-mastectomy imaging and biopsies.
- To inform patient expectations regarding follow-up care after mastectomy.
Main Methods:
- Retrospective review of unilateral mastectomy (UM) and bilateral mastectomy (BM) cases.
- Analysis of post-mastectomy imaging studies (ultrasound, MRI).
- Determination of biopsy rates and histopathological findings.
Main Results:
- Between 2009-2015, 185 UM and 200 BM cases were reviewed.
- 10% of UM patients and 15.5% of BM patients underwent subsequent imaging.
- 6% of UM patients and 8% of BM patients underwent biopsy, with a 1% overall malignancy yield.
Conclusions:
- Subsequent imaging is required for 10-15.5% of mastectomy patients.
- Biopsies are performed in 6-8% of cases, with a low malignancy detection rate.
- Mastectomy does not eliminate the need for imaging and biopsy, impacting surgical decision-making.
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