TY - JOUR
T1 - Variability of postsurgical imaging surveillance of breast cancer patients
T2 - A nationwide survey study
AU - Patel, Bhavika K.
AU - Lee, Cindy S.
AU - Kosiorek, Heidi E.
AU - Newell, Mary S.
AU - Pizzitola, Victor J.
AU - D'Orsi, Carl J.
N1 - Publisher Copyright:
�© American Roentgen Ray Society.
PY - 2018/1
Y1 - 2018/1
N2 - OBJECTIVE. Because of observed clinical variance and the discretion of referring physicians and radiologists in patient follow-up, the purpose of this study was to conduct a survey to explore whether broad discrepancy exists in imaging protocols used for postsurgical surveillance. SUBJECTS AND METHODS. An online survey was created to assess radiologists' use of diagnostic versus screening mammography for women with a personal history of breast cancer and determine whether the choice of protocol was associated with practice characteristics (setting, region, and reader type). RESULTS. Of 8170 surveys sent, 849 (10%) completed responses were returned. Seventy-nine percent of respondents recommended initial diagnostic mammography after lumpectomy (65% at 6 months, 14% at 12 months); 49% recommended diagnostic surveillance for up to 2 years before a return to screening mammography; and 33% continued diagnostic surveillance for 2–5 years before returning to screening. For imaging after mastectomy, 57% of respondents recommended diagnostic mammography of the unaffected breast. Among the 57%, however, 37% recommended diagnostic screening for only the first postmastectomy follow-up evaluation, and the other 20% permanently designated patients for diagnostic mammography after mastectomy. CONCLUSION. The optimal surveillance mammography regimen must be better defined. This preliminary study showed variability in diagnostic versus screening surveillance mammography for women with a history of breast cancer. Future studies should evaluate why these variations occur and how to standardize recommendations to tailor personalized imaging.
AB - OBJECTIVE. Because of observed clinical variance and the discretion of referring physicians and radiologists in patient follow-up, the purpose of this study was to conduct a survey to explore whether broad discrepancy exists in imaging protocols used for postsurgical surveillance. SUBJECTS AND METHODS. An online survey was created to assess radiologists' use of diagnostic versus screening mammography for women with a personal history of breast cancer and determine whether the choice of protocol was associated with practice characteristics (setting, region, and reader type). RESULTS. Of 8170 surveys sent, 849 (10%) completed responses were returned. Seventy-nine percent of respondents recommended initial diagnostic mammography after lumpectomy (65% at 6 months, 14% at 12 months); 49% recommended diagnostic surveillance for up to 2 years before a return to screening mammography; and 33% continued diagnostic surveillance for 2–5 years before returning to screening. For imaging after mastectomy, 57% of respondents recommended diagnostic mammography of the unaffected breast. Among the 57%, however, 37% recommended diagnostic screening for only the first postmastectomy follow-up evaluation, and the other 20% permanently designated patients for diagnostic mammography after mastectomy. CONCLUSION. The optimal surveillance mammography regimen must be better defined. This preliminary study showed variability in diagnostic versus screening surveillance mammography for women with a history of breast cancer. Future studies should evaluate why these variations occur and how to standardize recommendations to tailor personalized imaging.
KW - Diagnostic mammography
KW - Postlumpectomy screening
KW - Screening mammography
KW - Surveillance mammography
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U2 - 10.2214/AJR.17.17923
DO - 10.2214/AJR.17.17923
M3 - Article
C2 - 29064749
AN - SCOPUS:85039167987
SN - 0361-803X
VL - 210
SP - 222
EP - 227
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 1
ER -