MAMMOGRAPHIC SURVEILLANCE OF BREAST-CANCER PATIENTS - SHOULD THE MASTECTOMY SITE BE IMAGED

OBJECTIVE. This study evaluated the usefulness of routine mammography of the mastectomy site in women who have been treated for breast carci noma. MATERIALS AND METHODS. From a retrospective review of medical re cords and mammographic examinations of 827 patients who had mastectomi es, the following information was obtained: demographic data, type of breast reconstruction (if any), length of follow-up after mastectomy, evidence of local recurrence, and results of physical examination of t he breast and mammography immediately before diagnosis of local recurr ence. RESULTS. Local recurrences of breast cancer were seen in 39 (4.5 %) of the 859 breasts in the study group. All patients had a physical examination of the breast and mammography within 3 months of the diagn osis of recurrent breast carcinoma. Mammography of the mastectomy site did not show any recurrences that were not suspected on the basis of physical examination. For two of 20 patients, spot-compression views o f palpable abnormalities showed thickening of the surgical scar. In fo ur patients with pain in the chest wall, no abnormalities were found o n physical examination or mammograms, but bone scintigrams showed meta stasis to the ribs. CONCLUSION. Our results indicate that mammographic imaging of the mastectomy site does not increase the detection of loc ally recurrent breast cancer.