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


METHODS
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).


CONCLUSIONS
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.
Lu
Wenli
W
Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands.
Schaapveld
Michael
M
Jansen
Liesbeth
L
Bagherzadegan
Emad
E
Sahinovic
Marko Mirza
MM
Baas
Peter C
PC
Hanssen
Leo M H C
LM
van der Mijle
Hans C J
HC
Brandenburg
Jan D
JD
Wiggers
Theo
T
De Bock
Geertruida H
GH
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000379:methods; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D009426:Netherlands / Q000453:epidemiology; D010349:Patient Compliance; D011159:Population Surveillance / Q000379:methods*; D011379:Prognosis