1. Recommendations for breast imaging follow-up of women with a previous history of breast cancer: position paper from the Italian Group for Mammography Screening (GISMa) and the Italian College of Breast Radiologists (ICBR) by SIRM
- Author
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Paolo Belli, Lauro Bucchi, Alberto Tagliafico, Chiara Zuiani, Massimo Calabrese, Alfonso Frigerio, Carlo Naldoni, Luca A. Carbonaro, Vania Galli, Livia Giordano, Paola Clauser, Antonio Rizzo, Adriana Paduos, Francesca Caumo, Pietro Panizza, Daniela Bernardi, Stefania Montemezzi, Eva Benelli, Beatrice Cavallo-Marincola, Paola Golinelli, Beniamino Brancato, Giovanna Mariscotti, Laura Martincich, Francesco Sardanelli, Gianni Saguatti, Chiara Fedato, Morrone D, Fiammetta Querci, Federica Pediconi, and Rubina M. Trimboli
- Subjects
030218 nuclear medicine & medical imaging ,Breast cancer ,0302 clinical medicine ,Mass Screening ,Breast ultrasound ,Societies, Medical ,Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA ,medicine.diagnostic_test ,Follow-up ,Mammography ,Screening ,Survivorship care ,Breast Neoplasms ,Consensus ,Female ,Humans ,Italy ,Neoplasm Recurrence, Local ,Risk Assessment ,Continuity of Patient Care ,Interventional radiology ,General Medicine ,Radiology, Nuclear Medicine and Imaging ,breast cancer ,follow-up ,mammography ,screening ,survivorship care ,breast neoplasms ,consensus ,female ,humans ,mass screening ,neoplasm recurrence ,local ,risk assessment ,societies medical ,continuity of patient care ,radiology ,nuclear medicine and imaging ,Local ,Radiology Nuclear Medicine and imaging ,030220 oncology & carcinogenesis ,Risk assessment ,medicine.medical_specialty ,Breast imaging ,Context (language use) ,03 medical and health sciences ,Medical ,medicine ,Radiology, Nuclear Medicine and imaging ,Mass screening ,Gynecology ,business.industry ,medicine.disease ,Neoplasm Recurrence ,Family medicine ,Breast Radiology ,Societies ,business - Abstract
Women who were previously treated for breast cancer (BC) are an important particular subgroup of women at intermediate BC risk. Their breast follow-up should be planned taking in consideration a 1.0-1.5 % annual rate of loco-regional recurrences and new ipsilateral or contralateral BCs during 15-20 years, and be based on a regional/district invitation system. This activity should be carried out by a Department of Radiology integrating screening and diagnostics in the context of a Breast Unit. We recommend the adoption of protocols dedicated to women previously treated for BC, with a clear definition of responsibilities, methods for invitation, site(s) of visits, methods for clinical and radiological evaluation, follow-up duration, role and function of family doctors and specialists. These women will be invited to get a mammogram in dedicated sessions starting from the year after the end of treatment. The planned follow-up duration will be at least 10 years and will be defined on the basis of patient's age and preferences, taking into consideration organizational matters. Special agreements can be defined in the case of women who have their follow-up planned at other qualified centers. Dedicated screening sessions should include: evaluation of familial/personal history (if previously not done) for identifying high-risk conditions which could indicate a different screening strategy; immediate evaluation of mammograms by one or, when possible, two breast radiologists with possible addition of supplemental mammographic views, digital breast tomosynthesis, clinical breast examination, breast ultrasound; and prompt planning of possible further workup. Results of these screening sessions should be set apart from those of general female population screening and presented in dedicated reports. The following research issues are suggested: further risk stratification and effectiveness of follow-up protocols differentiated also for BC pathologic subtype and molecular classification, and evaluation of different models of survivorship care, also in terms of cost-effectiveness.
- Published
- 2016