Mastectomy follow-up by biennial mammograms: is it worthwhile?

The value of follow-up after mastectomy for breast cancer is controversial. One reason is to detect metachronous tumour in the contralateral breast, b ut the optimum method for achieving this is undecided. The long-term follow -up policy of our unit is annual clinical review combined with biennial mam mography. We have assessed the benefit of this policy in the detection of t umours of the contralateral breast. The case notes of 216 patients undergoi ng mastectomy between 1978 and 1985, under the care of one consultant surge on (DJTW) were reviewed. Follow-up was complete to December 1997, thus allo wing a minimum follow-up of 12 years. The development of a metachronous tum our was recorded as was its method of detection : either clinically, by the patient or the clinician, or by routine mammography. Two-hundred and five patients were available for follow-up of the contralateral breast. Seventee n (8.3%) developed metachronous tumours. Eight were detected by the patient , 4 by the clinician and 5 by routine follow-up mammography. Biennial mammo graphy does not appear to be beneficial in breast cancer follow-up. More wo rk is required to determine the benefits of more frequent mammography, with or without breast self-examination and clinical review within the hospital environment or within primary care. (C) 2000 Harcourt Publishers Ltd.