The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer

Lu, Wenli; Schaapveld, Michael; Jansen, Liesbeth; Bagherzadegan, Emad; Sahinovic, Marko Mirza; Baas, Peter C.; Hanssen, Leo M.H.C.; van der Mijle, Hans C.J.; Brandenburg, Jan D.; Wiggers, Theo; De Bock, Geertruida H.

doi:10.1016/j.ejca.2009.08.007

« Previous Next »European Journal of Cancer
Volume 45, Issue 17 , Pages 3000-3007, November 2009

The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer

Wenli Lu
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands
- Department of Health Statistics, School of Public Health, Tianjin Medical University, China
- Department of Epidemiology, Tianjin Medical University Cancer Institute and Hospital, China
Michael Schaapveld
- Comprehensive Cancer Centre North-Netherlands, Groningen, The Netherlands
Liesbeth Jansen
- Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
Emad Bagherzadegan
- Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
Marko Mirza Sahinovic
- Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
Peter C. Baas
- Department of Surgery, Martiniziekenhuis, Groningen, The Netherlands
Leo M.H.C. Hanssen
- Department of Surgery, Diaconessenhuis, Meppel, The Netherlands
Hans C.J. van der Mijle
- Department of Surgery, Maatschap Heelkunde Zuid Friesland, Nije Smellinghe, Drachten, The Netherlands
Jan D. Brandenburg
- Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
Theo Wiggers
- Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
Geertruida H. De Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands
- Corresponding author: Tel.: +31 50 3618061; fax: +31 50 3614493.

Received 6 March 2009; received in revised form 6 August 2009; accepted 11 August 2009. published online 10 September 2009.

Abstract

Purpose

To determine the contribution of surveillance mammography to the early detection of metachronous contralateral breast cancer (MCBC) and to assess its impact on the survival of breast cancer patients with relation to compliance.

Method

Breast cancer patients (5589) were identified using files from the regional cancer registry of the Comprehensive Cancer Centre North Netherlands (CCCN Groningen, The Netherlands). The programme sensitivity and the impact on prognosis of follow-up mammography with relation to compliance were evaluated in 114 patients who developed MCBC during hospital follow-up.

Results

The cumulative MCBC incidence rate at year 10 was 3.4% (95% CI: 2.8–4.0%). The programme sensitivity of surveillance mammography was 59.6% (95% CI: 50.6–68.7). In patients who complied with annual mammography, sensitivity was increased to 70.8% (95% CI: 61.7–80.0). Patients with MCBCs detected by routine mammography have better survival rates than patients with MCBCs detected by other means (HR: 3.18; 95% CI: 1.59–6.34). Though there was a trend towards improved survival in patients being compliant with regular clinical follow-up (HR: 1.69; 95% CI: 0.72–3.96), this was not the case for patients being compliant with annual mammography (HR:1.02; 95% CI:0.50–2.09).

Conclusion

Mammography is a valuable tool for the early detection of MCBC during hospital follow-up of breast cancer patients and is probably beneficial to survival. The utilisation of follow-up surveillance in breast cancer patients and its potential impact on survival deserve further investigation.

Keywords: Breast neoplasm, Contralateral breast cancer (CBC), Surveillance mammography