Recommendations for breast imaging follow-up of women with a previous history of breast cancer: position paper from the Italian Group for Mammography Screening (GISMa) and the Italian College of Breast Radiologists (ICBR) by SIRM.
Women who were previously treated for breast cancer (BC) are an important particular subgroup of women at intermediate BC risk. Their breast follow-up should be planned taking in consideration a 1.0-1.5 % annual rate of loco-regional recurrences and new ipsilateral or contralateral BCs during 15-20 years, and be based on a regional/district invitation system. This activity should be carried out by a Department of Radiology integrating screening and diagnostics in the context of a Breast Unit. We recommend the adoption of protocols dedicated to women previously treated for BC, with a clear definition of responsibilities, methods for invitation, site(s) of visits, methods for clinical and radiological evaluation, follow-up duration, role and function of family doctors and specialists. These women will be invited to get a mammogram in dedicated sessions starting from the year after the end of treatment. The planned follow-up duration will be at least 10 years and will be defined on the basis of patient's age and preferences, taking into consideration organizational matters. Special agreements can be defined in the case of women who have their follow-up planned at other qualified centers. Dedicated screening sessions should include: evaluation of familial/personal history (if previously not done) for identifying high-risk conditions which could indicate a different screening strategy; immediate evaluation of mammograms by one or, when possible, two breast radiologists with possible addition of supplemental mammographic views, digital breast tomosynthesis, clinical breast examination, breast ultrasound; and prompt planning of possible further workup. Results of these screening sessions should be set apart from those of general female population screening and presented in dedicated reports. The following research issues are suggested: further risk stratification and effectiveness of follow-up protocols differentiated also for BC pathologic subtype and molecular classification, and evaluation of different models of survivorship care, also in terms of cost-effectiveness.
Romagna Cancer Registry, Romagna Cancer Institute (IRST) IRCCS, via Piero Maroncelli, 40, 47014, Meldola, Forlì, Italy.
Lauro
L
Bucchi
Dipartimento di Scienze Radiologiche, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 0168, Rome, Italy.
Paolo
P
Belli
Zadig Scientific Communication Agency, via Arezzo 21, 00161, Rome, Italy.
Eva
E
Benelli
Dipartimento di Radiologia, U.O. Senologia Clinica e Screening Mammografico, APSS, Centro per i Servizi Sanitari, Pal. C, viale Verona, 38123, Trento, Italy.
Daniela
D
Bernardi
Struttura Complessa di Senologia Clinica, Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Via Cosimo il Vecchio 2, 50139, Florence, Italy.
Beniamino
B
Brancato
UOC Senologia Diagnostica, IRCCS AOU San Martino-IST, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
Massimo
M
Calabrese
Unit of Radiology, Research Hospital (IRCCS) Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy.
Luca A
LA
Carbonaro
UOSD Breast Unit ULSS20, Piazza Lambranzi 1, 37142, Verona, Italy.
Francesca
F
Caumo
Dipartimento di Scienze Radiologiche, Oncologiche ed Anatomo-patologiche, Policlinico Umberto I, Sapienza Università di Roma, Viale Regina Elena 324, 00161, Rome, Italy.
Beatrice
B
Cavallo-Marincola
Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna/General Hospital Vienna, Waehringer Guertel 18-20, 1090, Verona, Austria.|Institute of Radiology, University of Udine, P.le S. M. della Misericordia 15, 33100, Udine, Italy.
Paola
P
Clauser
Regional Screening Coordinating Centre, Veneto Region, Venice, Italy.
Chiara
C
Fedato
Regional Reference Centre for Breast Cancer Screening, Turin, Italy.
Alfonso
A
Frigerio
Mammography Screening Centre, Local Health Authority, Modena, Italy.
Vania
V
Galli
Epidemiology Unit, Centre for Cancer Prevention, Turin, Italy.
Livia
L
Giordano
Medical Physics Service, Local Health Authority, Modena, Italy.
Paola
P
Golinelli
Dipartimento di Diagnostica per Immagini, Radiologia 1U, Università di Torino, A. O. U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Turin, Italy.
Giovanna
G
Mariscotti
U.O. Radiodiagnostica, Candiolo Cancer Institute-FPO, IRCCS, Str. Prov. 142, km 3.95, I, 10060, Candiolo, Turin, Italy.
Laura
L
Martincich
DAI Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata, P.le A. Stefani 1, 37126, Verona, Italy.
Stefania
S
Montemezzi
Struttura Complessa di Senologia Clinica, Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Via Cosimo il Vecchio 2, 50139, Florence, Italy.
Doralba
D
Morrone
Department of Health, Emilia-Romagna Region, Bologna, Italy.
Carlo
C
Naldoni
Epidemiology Unit, Centre for Cancer Prevention, Turin, Italy.
Adriana
A
Paduos
U.O. Radiologia Senologica, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
Pietro
P
Panizza
Dipartimento di Scienze Radiologiche, Oncologiche ed Anatomo-patologiche, Policlinico Umberto I, Sapienza Università di Roma, Viale Regina Elena 324, 00161, Rome, Italy.
Federica
F
Pediconi
Department of Prevention, Screening Centre, Local Health Authority, Sassari, Italy.
Fiammetta
F
Querci
Pathology Department, Local Health Authority, Asolo, Italy.
Antonio
A
Rizzo
Senology Unit, Local Health Authority, Bologna, Italy.
Gianni
G
Saguatti
Department of Experimental Medicine, DIMES, Institute of Anatomy, University of Genova, Via de Toni 14, 16132, Genoa, Italy.
Alberto
A
Tagliafico
Unit of Radiology, Research Hospital (IRCCS) Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy.
Rubina M
RM
Trimboli
Institute of Radiology, University of Udine, P.le S. M. della Misericordia 15, 33100, Udine, Italy.
Chiara
C
Zuiani
Unit of Radiology, Research Hospital (IRCCS) Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy. francesco.sardanelli@unimi.it.|Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy. francesco.sardanelli@unimi.it.
Francesco
http://orcid.org/0000-0001-6545-9427
F
Sardanelli
D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D032921:Consensus; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D007558:Italy; D008327:Mammography; D008403:Mass Screening; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology*; D018570:Risk Assessment; D012955:Societies, Medical
Breast cancer; Follow-up; Mammography; Screening; Survivorship care