Yield of Surveillance Mammography in Autologous Reconstructed Breasts After Mastectomy: A Tertiary Care Study

The primary outcome of this study was to determine the cancer detection rate (CDR) of surveillance mammography in the autologous reconstructed breast post mastectomy.

In this research ethics board approved retrospective study, chart review was performed at a single academic centre to identify women who had undergone mastectomy with AR who underwent annual mammography surveillance of both ipsilateral (reconstructed) and contralateral breasts with a minimum 1 year of clinical and imaging follow-up between 2012 and 2020. Clinical information, imaging, method of detection, pathology and immunohistochemical findings, location of ipsilateral malignancy, and the interval between mastectomy and loco-regional recurrence (LRR) were calculated. The CDR of surveillance mammography, interval cancers, abnormal recall rate (ACR), and PPV1, PPV2, and PPV3 were determined.

We included 2127 screening examinations in 371 patients median age was 58 years (25-86 years). The average number of screens per patient was 5.73 (range: 1-17). No screen-detected cancers (CDR 0/1000) were identified in the ipsilateral breast for an abnormal recall rate of 0.42% (9/2127) and 3 benign biopsies. Three interval cancers were detected clinically in the ipsilateral breast.

No benefit was found for surveillance mammography and detection of non-palpable cancers in autologous reconstructed breasts post mastectomy in this study. Further multicentric studies with larger number of patients may be needed for confirmation of lack of benefit.