Breast Imaging: Screening for New Breast Cancers and for Cancer Recurrence
Breast cancer survivors require a unique breast imaging approach to identify new cancers as well as cancer recurrences. In this patient population, appropriate imaging requires some combination of digital mammography, digital breast tomosynthesis, ultrasound, and magnetic resonance imaging. The appropriate imaging modalities and intervals for imaging depend on many factors, including lifetime risk of malignancy, surgical history, breast density, medical comorbidities, and patient preference, among others. In general, more intensive surveillance imaging is performed in the first 5 years after diagnosis, due to a higher risk of recurrence within that time interval. Patients and providers must also be aware that many normal, treatment-related changes in the breast can be worrisome for breast cancer recurrence on breast imaging, without appropriate diagnostic workup. Because women with a history of breast cancer are living longer, short- and long-term management strategies for breast imaging must be individualized to provide the highest quality care.
