Table of Contents  

Mammography screening and follow-up of breast cancer

L Ponhold, H Bickel, K Pinker, Thomas H. Helbich
Published in : HAMDAN MEDICAL JOURNAL ; Vol 5, No 1 (2012)
DOI : 10.7707/hmj.v5i1.104


Breast cancer is the leading cause of cancer death among women worldwide. Imaging plays a key role in the early detection of breast cancer, and there is strong evidence that mammography screening has proven to be effective in reducing breast cancer mortality. Organized mammography screening programmes have been established around the globe, mostly in developed countries. Screening is important for an early diagnosis; however, the follow-up of patients with breast cancer is of importance, too. This review article is divided into two sections. The first section provides a general overview of mammography screening, including quality standards, controversial issues and aspects of high-risk screening. In the second section, we describe the potential uses of imaging modalities in the follow-up of breast cancer patients.

View article in  :   HTML     PDF     Flip


Akeson P, Larsson EM, Kristoffersen DT, et al. Brain metastases: Comparison of gadodiamide injection-enhanced MR imaging at standard and high dose, contrast-enhanced CT and noncontrast-enhanced MR imaging. Acta Radiol 1995; 36: 300–6.

Albrecht T, Hoffmann C, Schmitz S, et al. Detection of liver metastases: comparison of contrast-enhanced phase inversion ultrasound and dual phase spiral CT with intraoperative sonographic correlation. Radiology 2000; 207 (P): 459.

Alexander FE, Anderson TJ, Brown HK, et al. 14 years of follow-up from the Edinburgh randomized trial of breast-cancer screening. Lancet 1999; 353:1903–8.

American Cancer Society. Global Cancer Facts And Figures 2008.

Andersson I, Janzon L. Reduced breast cancer mortality in women under age 50: updated results from the Malmö Mammographic Screening Program. J Natl Cancer Inst Monogr 1997; 22:63–7.

Ashkanani F, Sarkar T, Needham G, et al. What is achieved by mammographic surveillance after breast conservation treatment for breast cancer? Am J Surg 2001; 182:207–10.

Asiago VM, Alvarado LZ, Shanaiah N, et al. Early detection of recurrent breast cancer using metabolite profiling. Cancer Res 2010; 70:8309–18.

Aukema TS, Rutgers EJ, Vogel WV, et al. The role of FDG PET/CT in patients with locoregional breast cancer recurrence: A comparison to conventional imaging techniques. EJSO 2010; 36:387–92.

Bakheet SM, Saleem M, Powe J, et al. F-18 fluorodeoxyglucose chest uptake in lung inflammation and infection. Clin Nucl Med 2000; 25:273–8.

Ba-Ssalamah A, Heinz-Peer G, Schima W, et al. Detection of focal hepatic lesions: comparison of unenhanced and SHU 555 A-enhanced MR imaging versus biphasic helical CTAP. J Magn Reson Imaging 2000; 11:665–72.<665::AID-JMRI13>3.0.CO;2-D

Bassett LW, Manjikian V 3rd, Gold RH. Mammography and breast cancer screening. Surg Clin North Am 1990; 70:775–800.

Baum M, Ravdin PM. Decision-making in early breast cancer: guidelines and decision tools. Eur J Cancer 2002; 38:745–9.

Bjurstam N, Björneld L, Warwick J, et al. The Gothenburg Breast Screening Trial. Cancer 2003; 97:2387–96.

Bluemke DA, Paulson EK, Choti MA, DeSena S, Clavien PA. Detection of hepatic lesions in candidates for surgery: comparison of ferumoxides-enhanced MR imaging and dual-phase helical CT. AJR Am J Roentgenol 2000; 175:1653–8. – Brest cancer risk factors. (accessed 29 December 2011).

Buchberger W, Niehoff A, Obrist P, DeKoekkoek-Doll P, Dünser M. Clinically and mammographically occult breast lesions: detection and classification with high-resolution sonography. Semin Ultrasound CT MR 2000; 21:325–36.

Chansakul T, Lai KC, Slanetz PJ. The postconservation breast: part 2, Imaging findings of tumour recurrence and other long-term sequelae. AJR Am J Roentgenol 2012; 198:331–43.

Chen W. Clinical applications of PET in brain tumors. J Nucl Med 2007; 48:1468–81.

Clarke MP, Kane RA, Steele Jr G, et al. Prospective comparison of preoperative imaging and intraoperative ultrasonography in the detection of liver tumors. Surgery 1989; 106:849–55.

Cobleigh MA, Vogel CL, Tripathy D, et al. Multinational study of the efficacy and safety of humanized anti-HER2 monoclonal antibody in women who have HER2-overexpressing metastatic breast cancer that has progressed after chemotherapy for metastatic disease. J Clin Oncol 1999; 17:2639–48.

Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet 2002; 360:187–95.

Colleoni M, O’Neill A, Gelber RD, et al. Subsequent sites of recurrence in patients with local, regional and soft tissue relapse: an analysis on 1217 cases. PASCO 1999; 300.

Corsetti V, Houssami N, Ferrari A, et al. Breast screening with ultrasound in women with mammography-negative dense breasts: evidence on incremental cancer detection and false positives, and associated cost. Eur J Cancer 2008; 44:539–44.

Cox CE, Greenberg H, Fleisher D, et al. Natural history and clinical evaluation of the lumpectomy scar. Am Surg 1993; 59:55–9.

Crowe JP Jr, Gordon NH, Antunez AR, Shenk RR, Hubay CA, Shuck JM. Local-regional breast cancer recurrence following mastectomy. Arch Surg 1991; 126: 429–32.

Daffner RH, Lupetin AR, Dash N, et al. MRI in the detection of malignant infiltration of bone marrow. AJRAm J Roentgenol 1986; 146:353–8.

Davis PC, Hudgins PA, Peterman SB, et al: Diagnosis of cerebral metastases: double dose delayed CT vs contrast-enhanced MR imaging. Am J Neuroradiol 1991; 12:293–300.

Dershaw DD, McCormick B, Cox L, et al. Differentiation of benign and malignant local tumor recurrence after lumpectomy. AJR 1990; 155:35–8.

Dershaw DD, Shank B, Reisinger S. Mammographic findings after breast cancer treatment with local excision and definitive irradiation. Radiology 1987; 164:455–61.

Dershaw DD. Evaluation of the breast undergoing lumpectomy and radiation therapy. Radiol Clin North Am 1995; 33:1147–60.

Dershaw DD. Mammography in patients with breast cancer treated by breast conservation (lumpectomy with or without radiation). AJR 1995; 164:309–16.

Dose-Schwarz J, Mahner S, Schirrmacher S, et al. Detection of metastases in breast cancer patients: comparison of FDG PET with chest X-ray, bone scintigraphy and ultrasound of the abdomen. Nuklearmedizin 2008; 47:97–103.

Drew PJ, Kerin MJ, Turnbull LW, et al. Routine screening for local recurrence following breast-conserving therapy for cancer with dynamic contrast-enhanced magnetic resonance imaging of the breast. Ann SurgOncol 1998; 5:265–70.

Edmunson H, Craig J. Neoplasms of the liver. In: Schriff ER, Sorrell MF, Maddrey WD (eds.) Schiff’sDiseases of the Liver, 8th edn. Philadelphia: Lippincott, 1999; p. 1109.

Evans AJ, Pinder SE, Ellis IO, Wilson AR. Screen detected ductal carcinoma in situ (DCIS): overdiagnosis or an obligate precursor of invasive disease? J Med Screen 2001; 8:149–51.

Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002; 347:1233–41.

Fisher B, Anderson S, Fisher ER, et al. Significance of ipsilateral breast tumour recurrence after lumpectomy. Lancet 1991; 338:327–31.

Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 1995; 333:1456–61.

Fisher BJ, Perera FE, Cooke AL, Opeitum A, Venkatesan V, Dar AR, Stitt L. Long-term follow-up of axillary node-positive breast cancer patients receiving adjuvant systemic therapy alone: patterns of recurrence. Int J Radiat Oncol Biol Phys 1997; 38:541–50.

Fisher ER, Anderson S, Redmond C, Fisher B. Ipsilateral breast tumour recurrence and survival following lumpectomy and irradiation: pathological findings from NSABP protocol B-06. Semin Surg Oncol 1992; 8:161–6.

Fowble B, Schwaibold F. Local-regional recurrence following definitive treatment for operable breast cancer. In: Fowble B, Goodman RL, Glick JH, Rosato EF (eds.) Breast Cancer Treatment: A Comprehensive Guide to Management. St Louis: Mosby-Year Book, 1991; pp. 373–402.

Frei KA, Kinkel K, Bonel HM, Lu Y, Esserman LJ, Hylton NM. MR imaging of the breast in patients with positive margins after lumpectomy: influence of the time interval between lumpectomy and MR imaging. AJRAm J Roentgenol 2000; 175:1577–84.

Galasko CS. Skeletal metastases and mammary cancer. Ann R Coll Surg Engl 1972; 50:3–28.

Galasko CS: The value of scintigraphy in malignant disease. Cancer Treat Rev 1975; 2:225–72.

Giess CS, Keating DM, Osborne MP, et al. Local tumor recurrence following breast-conservation therapy: correlation of histopathologic findings with detection method and mammographic findings. Radiology 1999; 212:829–35.

Giordano SH, Cohen DS, Buzdar AU, Perkins G, Hortobagyi GN. Breast carcinoma in men: a population-based study. Cancer 2004; 101:51–7.

Goldhirsch A, Gelber RD, Castiglione M. Relapse of breast cancer after adjuvant treatment in premenopausal and perimenopausal women: patterns and prognoses. J Clin Oncol 1988; 6:89–97.

Goldhirsch A, Gelber RD, Price KN, et al. Effect of systemic adjuvant treatment on first sites of breast cancer relapse. Lancet 1994; 343:377–81.

Hassell PR, Olivotto IA, Mueller HA, Kingston GW, Basco VE. Early breast cancer: detection of recurrence after conservative surgery and radiation therapy. Radiology 1990; 176:731–5.

Haug AR, Schmidt GP, Klingenstein A, et al. F-18-fluoro-2-deoxyglucose positron emission tomography/computed tomography in the follow-up of breast cancer with elevated levels of tumor markers. JComput Assist Tomogr 2007; 31:629–34.

Hendrick RE, Smith RA, Rutledge JH 3rd, Smart CR. Benefit of screening mammography in women aged 40–49: a new meta-analysis of randomized controlled trials. J Natl Cancer Inst Monogr 1997; 22:87–92.

Hendrick RE, Smith RA, Rutledge JH 3rd, Smart CR. Benefit of screening mammography in women aged 40–49: a new meta-analysis of randomized controlled trials. J Natl Cancer Inst Monogr 1997; 22:87–92.

Hortobagyi GN, Libshitz HI, Seabold JE. Osseous metastases of breast cancer. Clinical, biochemical, radiographic, and scintigraphic evaluation of response to therapy. Cancer 1984; 53:577–82.<577::AID-CNCR2820530335>3.0.CO;2-U

Houssami N, Costelloe CM. Imaging bone metastases in breast cancer: evidence on comparative test accuracy. Ann Oncol [Epub ahead of print].

Humphrey LL, Helfand M, Chan BK, Woolf SH. Breast cancer screening: a summary of the evidence for the U.S. Preventative Services Task Force. Ann Intern Med 2002;137:347–60.

Jatoi I, Tsimelzon A, Weiss H, Clark GM, Hilsenbeck SG. Hazard rates of recurrence following diagnosis of primary breast cancer. Breast Cancer Res Treat 2005; 89:173.

Jeyapalan SA, Batchelor TT: Diagnostic evaluation of neurologic metastases. Cancer Invest 2000; 18:381–94.

Kamby C, Rose C, Ejlertsen B, et al. Stage and pattern of metastases in patients with breast cancer. Eur J Cancer Clin Oncol 1987; 23:1925–34.

Kaplan SS. Clinical utility of bilateral whole-breast US in the evaluation of women with dense breast tissue. Radiology 2001; 221:641–9.

Kerlikowske K, Grady D, Ernster V. Benefit of mammography screening in women ages 40–49 years: current evidence from randomized controlled trials. Cancer 1995; 76:1679–81.<1679::AID-CNCR2820760928>3.0.CO;2-Y

Kerlikowske K. Screening mammography in women less than age 50 years. Curr Opin Obstet Gynecol 2012; 24:38–43.

Kido DK, Gould R, Taati F, et al. Comparative sensitivity of CT scans, radiographs and radionuclide bone scans in detecting metastatic calvarial lesions. Radiology 1978; 128:371–5.

Kim MJ, Kim EK, Kwak JY, et al. Role of sonography in the detection of contralateral metachronous breast cancer in an Asian population. Am J Roentgenol 2008; 190:476–80.

Kim MJ, Kim EK, Kwak JY, et al. Sonographic surveillance for the detection of contralateral metachronous breast cancer in an Asian population. Am J Roentgenol 2009; 192:221–8.

Kim SJ, Moon WK, Cho N, Chang JM. The detection of recurrent breast cancer in patients with a history of breast cancer surgery: comparison of clinical breast examination, mammography and ultrasonography. Acta Radiol 2011; 52:15–20.

Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology 2002; 225:165–75.

Kolb TM, Lichy J, Newhouse JH. Occult cancer in women with dense breasts: detection with screening US – diagnostic yield and tumour characteristics. Radiology 1998; 207:191–9.

Kuhl C, Weigel S, Schrading S, et al. Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA trial. J Clin Oncol 2010; 28:1450–7.

Kuhl CK. Current status of breast MR imaging. Part 2. Clinical applications. Radiology 2007; 244:672–91.

Kurtz JM, Amalric R, Brandone H, et al. Local recurrence after breast-conserving surgery and ra­diotherapy: frequency, time course, and prognosis. Cancer 1989; 63:1912–17.<1912::AID-CNCR2820631007>3.0.CO;2-Y

Locker AP, Hanley P, Wilson AR, et al. Mammography in the pre-operative assessment and post-operative surveillance of patients treated by excision and radiotherapy for primary breast cancer. Clin Radiol 1990; 41:388–91.

Mahner S, Schirrmacher S, Brenner W, et al. Comparison between positron emission tomography using 2-[fluorine-18]fluoro-2-deoxy-D-glucose, conventional imaging and computed tomography for staging breast cancer. Ann Oncol 2008; 19:1249–54.

Mandelson MT, Oestreicher N, Porter PL, et al. Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst 2000; 92:1081–7.

Miller AB, To T, Baines CJ, Wall C. Canadian National Breast Screening Study-2: 13-year results of a randomized trial in women aged 50–59 years. J Natl Cancer Inst 2000;92:1490–9.

Miller AB, To T, Baines CJ, Wall C. The Canadian National Breast Screening Study-1: breast cancer mortality after 11 to 16 years of follow-up. A randomized screening trial of mammography in women age 40 to 49 years. Ann Intern Med 2002; 137:305–12.

Miller AB, To T, Baines CJ, Wall C. The Canadian National Breast Screening Study-1: breast cancer mortality after 11 to 16 years of follow-up. A randomized screening trial of mammography in women age 40 to 49 years. Ann Intern Med 2002; 137:305–12.

Moon HJ, Kim MJ, Kim EK, et al. US surveillance of regional lymph node recurrence after breast cancer surgery. Radiology 2009; 252:673–81.

Moss SM, Cuckle H, Evans A, Johns L, Waller M, Bobrow L; Trial Management Group. Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years’ follow-up: a randomized controlled trial. Lancet 2006; 368:2053–60.

Moy L, Ponzo F, Noz ME, et al. Improving specificity of breast MRI using prone PET and fused MRI and PET 3D volume datasets. J Nucl Med 2007; 48:528–37.

Murakami R, Kumita S, Yoshida T, et al. FDG-PET/CT in the diagnosis of recurrent breast cancer. Acta Radiol 2012; 53:12–16.

Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L; U.S. Preventative Services Task Force. Screening for breast cancer: an update for the U.S. Preventative Services Task Force. Ann Intern Med 2009; 151:727–37, W237–42.

Nunes LW, Schnall MD, Orel SG. Update of breast MR imaging architectural interpretation model. Radiology 2001; 219:484–44.

Nyström L, Andersson I, Bjurstam N, Frisell J, Nordenskjöld B, Rutqvist LE. Long-term effects of mammography screening: updated overview of the Swedish randomized trials. Lancet 2002; 359:909–19.

Nyström L, Andersson I, Bjurstam N, Frisell J, Nordenskjöld B, Rutqvist LE. Long-term effects of mammography screening: updated overview of the Swedish randomized trials. Lancet 2002; 359:909–19.

O’Donell W, Venet L, Day E. Progress in cancer detection. I. Rationale, methods and selection of patients. CA Cancer J Clin 1958; 8:186–96.

O’Mara RE: Skeletal scanning in neoplastic disease. Cancer 1976; 37:480–6.<480::AID-CNCR2820370713>3.0.CO;2-2

Ohlmann-Knafo S, Kirschbaum M, Fenzl G, Pickuth D. Diagnostic value of whole-body MRI and bone scintigraphy in the detection of osseous metastases in patients with breast cancer – a prospective double-blinded study at two hospital centers. Rofo 2009; 181:255–63.

Ohlsson B, Tranberg KG, Lundstedt C, et al. Detection of hepatic metastases in colorectal cancer: a prospective study of laboratory and imaging methods. Eur J Surg 1993; 159:275–81.

Orel SG, Troupin RH, Patterson EA, et al. Breast cancer recurrence after lumpectomy and irradiation: role of mammography in detection. Radiology 1992; 183:201–6.

Perry N, Broeders M, de Wolf C, Törnberg S, Holland R, von Karsa L. European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis, 4th edn. Luxembourg: Office for Official Publications of the European Communities, 2006.

Recht A, Silen W, Schnitt SJ, et al. Time-course of local recurrence following conservative surgery and radiotherapy for early stage breast cancer. Int J Radiat Oncol Biol Phys 1988; 15:255–61.

Riedl CC, Ponhold L, Flöry D, et al. Magnetic resonance imaging of the breast improves detection of invasive cancer, preinvasive cancer, and premalignant lesions during surveillance of women at high risk for breast cancer. Clin Cancer Res 2007; 13:6144–52.

Riedl CC, Ponhold L, Gruber R, Pinker K, Helbich TH. New information on high risk breast screening. Radiologe 2010; 50:955–6, 958–63.

Rinaldi P, Giuliani M, Belli P, et al. DWI in breast MRI: role of ADC value to determine diagnosis between recurrent tumor and surgical scar in operated patients. Eur J Radiol 2010; 75:e114–23.

Rybak LD, Rosenthal DI. Radiological imaging for the diagnosis of bone metastases. Q J Nucl Med 2001; 45:53–64.

Santoro, E., DeSoto, M., Hong Lee, J. Hormone Therapy and Menopause. National Research Center for Women & Families (February 2009).

Sardi A, Eckholdt G, McKinnon WM, et al. The significance of mammographic findings after breast-conserving therapy for carcinoma of the breast. Surg Gynecol Obstet 1991; 173:309–12.

Schnall MD, Blume J, Bluemke DA, et al. Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology 2006; 238:42–53.

Shapiro S. Periodic screening for breast cancer: the HIP Randomized Controlled Trial. Health Insurance Plan. J Natl Cancer Inst Monogr 1997; 22:27–30.

Shapiro S. The status of breast cancer screening: a quarter of a century of research. World J Surg 1989; 13:9–18.

Shin JH, Han BK, Choe YH, et al. Ultrasonographic detection of occult cancer in patients after surgical therapy for breast cancer. J Ultrasound Med 2005; 24:643–9.

Silverstein MJ, Skinner KA, Lomis TJ. Predicting axillary nodal positivity in 2282 patients with breast carcinoma. World J Surg 2001; 25:767–72 [Epub ahead of print].

Smart CR, Hendrick RE, Rutledge JH 3rd, Smith RA. Benefit of mammography screening in women ages 40 to 49 years. Current evidence from randomized controlled trials. Cancer 1995;75:1619–26.

Smith R. IARC Handbook ofCancer Prevention, Vol. 7: Breast Cancer Screening. Lyon: IARC; 2002, p. 24.

Smith RA. International programs for the detection of breast cancer. Salud Publica Mex 2011; 53:394–404.

Stomper PC, D’Souza DJ, DiNitto PA, Arredondo MA. Analysis of parenchymal density on mammograms in 1353 women 25–79 years old. AJR Am J Roentgenol 1996; 167:1261–5.

Straathof CSM, deBruin HG, Dippel DWJ, et al. The diagnostic accuracy of magnetic resonance imaging and cerebrospinal fluid cytology in leptomeningeal metastasis. J Neurol 1999; 246:810–14.

Strnad V, Hildebrandt G, Pötter R, et al. Accelerated partial breast irradiation: 5-year results of the German-Austrian multicenter phase II trial using interstitial multicatheter brachytherapy alone after breast-conserving surgery. Int J Radiat Oncol Biol Phys 2011; 80:17–24.

Sze G, Milano E, Johnson C, et al. Detection of brain metastasis: comparison of contrast enhanced MR with unenhanced MR and enhanced CT. Am J Neuroradiol 1990; 11:785–91.

Tabár L, Vitak B, Chen TH, et al. Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades. Radiology 2011; 260:658–63 [Epub ahead of print].

Teh W, Wilson AR. The role of ultrasound in breast cancer screening. A consensus statement by the European Group for Breast Cancer Screening. Eur J Cancer 1998; 34:449–50.

Tuli R, Christodouleas J, Roberts L, et al. Prognostic indicators following ipsilateral tumor recurrence in patients treated with breast-conserving therapy. Am J Surg 2009; 198:557–61.

Van den Bosch H, Seynaeve P, Kockx MM, Storms JL. Radiological guidelines for the detection of early breast cancer: a review. J Belge Radiol 1990; 73:339–56.

Venturi S. Is there a role for iodine in breast diseases? Breast 2001; 10:379–82.

Vora SA, Wazer DE, Homer MJ. Management of microcalcifications that develop at the lumpectomy site after breast-conserving therapy. Radiology 1997; 203:667–71.

Wapnir I, Anderson S, Mamounas E, et al. Survival after IBTR in NSABP node negative protocols B-13, B-14, B-19, B-20 andB-23. J Clin Oncol 2005; 23:8s.

Ward J, Naik KS, Guthrie JA, Wilson D, Robinson PJ. Hepatic lesion detection: comparison of MR imaging after the administration of superparamagnetic iron oxide with dual-phase CT by using alternative-free response receiver operating characteristic analysis. Radiology 1999; 210:459–66.

Warner E. Clinical practice. Breast-cancer screening. N Engl J Med 2011; 365:1025–32.

Wernecke K, Rummeny E, Bongartz G, et al. Detection of hepatic masses in patients with carcinoma: comparative sensitivities of sonography, CT, and MR imaging. Am J Roentgenol 1991; 157:731–9.

Yager JD, Davidson NE. Oestrogen carcinogenesis in breast cancer. N Engl J Med 2006;354:270–82.

View all comments  |  Add comment 

Home  Editorial Board  Search  Current Issue  Archive Issues  Announcements  Aims & Scope  About the Journal  How to Submit  Contact Us
Find out how to become a part of the HMJ  |   CLICK HERE >>
© Copyright 2012 - 2013 HMJ - HAMDAN Medical Journal. All Rights Reserved         Website Developed By Cedar Solutions INDIA