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While women's health programs advise mammography screening to detect early stage breast cancer, far less focus is placed on the screening needs of breast cancer survivors or the risk of recurrences. A new study published in the Feb. 23, 2011 issue of the Journal of the American Medical Association indicated that mammography alone may not be adequate for those with a history of breast cancer. The authors, who believe this is the first comprehensive study of this issue, advise women to work with their oncologists to develop a personalized screening strategy as part of their survivorship program.
While annual mammograms help detect second breast cancers, the study showed they were more effective in women who have never had the disease. Survivors were more likely to have false positives - a cancer finding that turns out to be benign after further testing. This is because women's breasts change after surgery and radiation, leading to results that can appear abnormal to a radiologist but are not.
The study also found that breast cancer survivors were more likely to have what are known as "interval cancers" - those found between mammograms due to symptoms or additional testing. This finding indicates women need to continue monitoring their breast health after treatment and report changes and symptoms to their oncologist immediately instead of waiting for an annual screening date.
"The high prevalence of breast cancer survivors is due to general gains in life expectancy and to improved survival in women with a personal history of breast cancer (PHBC), attributable to improvements in local and systemic treatments and early detection," the authors write. Women with PHBC are at risk of developing second breast cancers and are recommended for annual screening mammography, but few high-quality data exist on screening accuracy in PHBC women, according to background information in the article.
The study was conducted by Nehmat Houssami, M.B.B.S., Ph.D., of the University of Sydney, Australia, with colleagues from the Breast Cancer Surveillance Consortium and Group Health Research Institute in Seattle, Wash.