Should women with implants or a history of treatment for breast cancer be excluded from mammography screening programs?
OBJECTIVE
Our objective was to determine whether it is scientifically justified to require that women with implants or a history of treatment for breast cancer be screened in a diagnostic mammography setting and that they be excluded from mammography screening programs.


METHODS
The recall rates for women with breast implants or a history of treatment for breast cancer who were screened in a dedicated mammography screening program were compared with those of other women in the screening program. The computerized records for the breast screening program of the Department of Radiology at our institution for January 1, 1990, through December 31, 1995, were reviewed. The recall rates for women who had breast implants and those for women with a history of treatment for breast cancer were compared with the recall rates for the other women who underwent screening. Each recall rate included women who were called back for additional evaluation in addition to those for whom a biopsy was recommended on the basis of the screening study.


RESULTS
Of 45,134 screening examinations done during the review period, 43,454 (96%) were for women who had no history of breast cancer or of breast implants; 590 (1%) were for women who had undergone mastectomy; 991 (2%) were for women who had been treated with lumpectomy and irradiation for breast cancer; and 99 (0.2%) were for women with breast implants. Among the 43,454 examinations of women with no history of breast cancer or implants, 3081 examinations (7%) led to interpretations that produced requests for the patient to return for additional evaluation. Thirty-six women who had been treated for breast cancer by mastectomy were recalled (6%). Seventy-five women who had undergone lumpectomy and irradiation for breast cancer were recalled (8%). Five women with breast implants were recalled (5%). Statistically, these rates were not significantly different.


CONCLUSIONS
We find no scientific reason to exclude women who have been treated for breast cancer or who have breast implants from dedicated screening programs.
Kopans
D B
DB
Department of Radiology, Massachusetts General Hospital, Boston, USA.
Moore
R H
RH
McCarthy
K A
KA
Hall
D A
DA
Hulka
C A
CA
Whitman
G J
GJ
Slanetz
P J
PJ
Halpern
E F
EF
D018427:Breast Implants; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D018579:Patient Selection