Breast Cancer Surveillance in Patients with a Personal History of Breast Cancer: Updates and Controversies

The increased survival rates for patients with a personal history of breast cancer (PHBC) can be attributed to early detection and advancements in breast cancer treatment. Imaging surveillance is of utmost importance due to the increased risk of local recurrence and the development of new primary breast cancer in patients with PHBC. National and international organizations recommend annual mammography for patients with PHBC; supplemental imaging modalities include contrast-enhanced mammography, whole-breast screening US, and breast MRI. However, the screening protocols and indications for supplemental imaging are significantly heterogeneous. The authors provide a review of current screening guidelines for patients with PHBC to aid understanding of the challenges involved in (a) determining when to initiate or discontinue screening mammography, (b) performing screening versus diagnostic mammography, and (c) performing offline versus live screening. The authors also provide updates on emergent supplemental imaging modalities and compliance with screening recommendations for patients with PHBC. ^©RSNA, 2025.