Surveillance mammography after treatment for primary breast cancer

The National Institute for Health Research Health Technology Assessment (NIHR HTA) programme has commissioned a new study to identify the most effective and efficient surveillance methods for women who have received treatment for primary breast cancer.

There are 45,000 new cases in the UK each year and although the majority of women never experience a recurrence, it does return in approximately 25 per cent of women. The majority of these recurrences are found during the first three years after treatment.

It is generally accepted that early diagnosis is a key factor influencing survival from breast cancer, with an 81 per cent reduction in mortality compared with women who were identified with more advanced stages. A recurrence of breast cancer might be found either by physical examination or by mammography, a process which uses low-dose X-rays to examine the breast. There is, however, no general agreement as to the best way to monitor patients for recurrence or how often women should receive X-rays.

The study, lead by Professor Fiona Gilbert of the University of Aberdeen is re-examining the data from existing research studies as well as data from clinicians and hospitals to assess the potential for reducing mortality through earlier detection of breast cancer while also considering the potential harms. The project will also investigate the cost-effectiveness of using mammography on a regular basis to identify the most appropriate method and recurrence.

Professor Gilbert says, "The key factor is to identify the best method for mammographic surveillance for patients after breast cancer treatment. In addition, we aim to look at alternative methods over the next three years to ascertain the most effective procedure for aftercare treatment and to estimate the cost-effectiveness of alternative follow-up schemes. In time we hope this will lead to an improvement in survival of women through a more efficient monitoring system."

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