UCSF Study Confirms Benefit of Semiannual Surveillance following Breast-Conserving Therapy

The following article was written by Edward A. Sickles, M.D, F.A.C.R., Professor Emeritus of Radiology and Section Chief of Breast Imaging, Department of Radiology and Biomedical Imaging at UCSF.

A recent UCSF study published in the August issue of Radiology confirms the benefit of undergoing semiannual surveillance mammography following breast-conserving therapy (BCT) as opposed to the existing guide-lines which recommend annual mammography screening. Up until this point, an optimal mammographic surveillance interval has yet to be widely established, but this research further enhances the UCSF Department of Radiology and Biomedical Image’s stance that semiannual exams save lives by detecting recurring cancer earlier.

Breast-conserving therapy, or BCT, is a standard treatment for patient’s who are diagnosed with small and early breast cancer. However, continual surveillance following the procedure is vital, as these women remain at risk for recurrence of breast cancer at a rate of one to two percent annually for ten years.

While the American Society for Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) suggest annual breast surveillance, little research has been done on the subject and these recommendations are based on expert opinion.

For this study, the team, lead by Vignesh A. Arasu, MD, compared cancer recurrence among post-BCT exam patients who followed the semiannual surveillance recommendations versus those who only underwent annual surveillance. The team analyzed 7,169 semiannual post-BST exams and 1,065 annual post-BST exams dating from 1997 through 2008. Of those women, all of which were similar in age and family history, 94 recurrences of breast cancer were found amongst the semiannual group versus 15 found amongst the annual group.

Most importantly, however, 94 percent of those recurrences among the semiannual group were stage 0 or stage 1. Amongst the annual group, only 74 percent were in either of these stages, with the remaining 26 percent of recurrences at stage 2. This means, that early detection during surveillance correlates with less- invasive cancer recurrence. And though the study did not examine cancer mortality, early detection may decrease mortality, as well deliver improvements in survival.

Of those who underwent BCT, 85 percent did comply with the semiannual protocol, a sign that most patients understand and will take advantage of the benefits of semiannual surveillance.

If you’re interested in learning more about breast cancer screening and UCSF’s recommendations, please see here. Remember, regular breast cancer screening saves lives.