Value of contralateral surveillance mammography for primary breast cancer follow-up

Mammographic screening of the contralateral breast is often advocated durin g follow-up of women previously treated for primary operable breast cancer. The purpose of this study was to determine the value of this investigation . Between 1987 and 1995 a total of 5102 contralateral screening mammograms were performed biennially on 2511 women aged less than or equal to 70 years following treatment fur primary operable breast cancer, Sixty-five metachr onous contralateral breast canters were identified: 21 (32%) at routine cli nical examination, 24 (37%) at mammography, and 20 (31%) by patients betwee n routine follow-up appointments. The prognostic features of metachronous c ancers were better or similar to those of the first cancer in 59 of 65 (91% ) cases, Because of the favorable prognostic characteristics of the contral ateral cancer, mammographic screening may have contributed to the long-term survival of 1.6 of 26 women in whom the histologic characteristics of the first cancer predicted a good prognosis, The cancer detection rate with mam mography for these women mas 6.5 per 1000 contralateral mammogram investiga tions at a cost of pound 3852 per cancer detected. The results of this stud y suggest that surveillance mammography of the contralateral breast is of v alue in women whose first cancer predicted a favorable prognosis.