Women still need breast imaging after mastectomy

Although women may be increasingly choosing mastectomy as a breast cancer treatment, the procedure does not eliminate the need for further breast imaging, according to a study published online in September in the Annals of Surgical Oncology.

A team led by Dr. Soojin Ahn from Icahn School of Medicine at Mount Sinai conducted the study, which included 185 unilateral and 200 bilateral mastectomies performed between 2009 and 2015. The average follow-up time was 30 months.

Of the 185 unilateral mastectomy patients, 10% underwent imaging on that side during the follow-up period, prompted by suspicious physical exam findings, while 6% had biopsies and 1% were eventually diagnosed with another malignancy (Ann Surg Oncol, September 10, 2018).

Of the 200 bilateral mastectomy patients, 15.5% required imaging (76% of this imaging was performed on the same side as the previous cancer). Among the 200 women, 8% had a biopsy (69% performed on the same side as the previous cancer) and 1.5% were diagnosed with another malignancy.

Although the rate of malignancy in this population is low, Ahn and colleagues noted that having a mastectomy does not eliminate the need for further imaging and/or biopsy.

"This information is critical for patient understanding and decision-making," said study co-author Dr. Elisa Port in a statement released by Mount Sinai. "Physicians and their patients should make their surgical treatment decisions after careful consideration of various clinical factors and realistic expectations for postoperative follow-up."

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