Monitoring

Regular physical examinations and annual mammography are as effective as more intensive monitoring following completion of primary treatment.[505] [ Cochrane Clinical Answers logo ]

Regular and thorough history, physical examination, and mammography should be the mainstay of long-term surveillance of breast cancer.[125][506]​​​ Early detection of isolated recurrences in patients without symptoms may improve survival of breast cancer patients.[507] All patients should undergo a detailed history and physical examination by a doctor who is experienced in the surveillance of cancer patients and in breast examinations.

History and physical examination should be 1-4 times each year for the first 5 years, and annually thereafter.[125]

Annual mammographic surveillance is recommended for women who have had breast-conserving therapy. Annual mammograms should not start until 6-12 months after completion of radiotherapy.​[125][508]​​​​

The clinical utility of breast MRI surveillance in women with a personal history of breast cancer is dependent upon risk factors identified in studied populations, in addition to institutional protocols.[509]

Whole-breast ultrasound, using hand-held or automated technique, may be used as a supplemental screening examination for women who are at high risk for developing secondary breast cancer.[79]​​​[509]​​​​​​​

Following mastectomy (with or without reconstruction [autologous or non-autologous]), imaging on the side of the mastectomy is not typically recommended for surveillance.[510] Breast ultrasound is usually appropriate to evaluate a woman with a palpable lump or clinically significant pain on the side of the mastectomy.[510]​​

The use of other laboratory tests (including tumour markers) and further body imaging is not recommended, unless clinically indicated.[125]

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