How Beneficial is Follow-Up Mammography in Elderly Breast Cancer Survivors?

Objective: The aim of this study was to determine the rate of non-palpable cancer detection and benign biopsy rates for follow-up mammograms in elderly breast cancer survivors.

Methods: Women 80 years of age and older who underwent operation for ductal carcinoma in situ or invasive breast cancer from 2005 to 2010 and who had at least 6 months of follow-up were identified from a single-institution, prospectively maintained, Health Insurance Portability and Accountability Act (HIPAA)-compliant database. Patients with mammographic, other imaging, or palpable abnormalities were identified, and the results of their imaging studies and biopsies were reviewed. Number of locoregional recurrences, contralateral cancers, and benign biopsies were determined. Follow-up and survival data were recorded.

Results: Overall, 429 women with a mean age of 83.4 years were included. Mean follow-up was 50.0 months (range 6-113). Patients had a median of four follow-up mammograms (range 0-11). The 1466 mammograms detected 17 biopsy-proven cancers and generated 18 benign biopsies. In the 305 women who had had breast-conserving surgery, 18 (5.9 %) experienced local recurrence, 9 detected by mammography alone (mean size 1.2 cm) and 9 palpable (mean size 2.0 cm). Contralateral cancer developed in 4 (0.9 %) of the 429 patients, all detected on screening mammogram alone.

Conclusion: Overall, 13 non-palpable breast cancers were detected in 1466 mammograms (0.9 %). While these results are acceptable for screening programs in healthy populations, further study of the need for routine follow-up imaging in the elderly, and the appropriate interval, is needed to maximize resource utilization.