Mammographic follow up: a vital component of breast cancer management

Women with proven breast cancer are at high risk for development of a second breast malignancy or a recurrence. An important component of clinical care is regular mammographic follow up, to enable preclinical diagnosis and avoid delay in treatment. One hundred and forty-two women with previous breast cancer attended a pilot mammographic screening program. Eleven had suspicious mammographic lesions, all clinically occult; nine breast cancers were diagnosed (two recurrences and seven new tumours). The cancer detection rate in this high-risk group of women was 6.3%, compared with 0.8% in 16,283 women screened with no history of breast cancer. Examination of the mammographic history of the 142 women showed that mammography was used infrequently as part of their clinical surveillance, and this led to a delay in diagnosis of the new or recurrent cancer. Recommendations for an appropriate regimen for use of mammography in new and established cases of breast cancer are made.