Breast Reconstruction: Q&A
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Do I Need Yearly Mammograms or MRI After Breast Cancer and Reconstruction?
I had mastectomy Oct 2008. Reconstruction finished June 2009. Do I need a yearly mammogram or MRI to continue to look for cancer?
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10 Doctor Answers |
Asked by
Good Karma
in Indiana
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Breast reconstruction, nipple reconstruction, breast cancer, DCIS, mastectomy, TUG flap, DIEP flap, Latissimus flap, fat graft i
Guidelines are set by the NCCN and should be followed by the oncologist and breast surgeon who manage your cancer care. Mammograms are not done when there is no breast tissue.
Austin Plastic Surgeon
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Follow-up studies
Oncologists differ in terms of follow-up some want it every other year and others want it yearly, you should speak with your oncologist.
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Breast Imaging and Surveilance after Mastectomy and Reconstruction
Breast surgeons and breast oncologists differ in opinion about the best method to monitor a woman after mastectomy and reconstruction. There is no single answer, and what is best for you will depend on a number of factors such as whether or not you are at increased genetic risk for breast cancer (e.g, BRCA gene mutation carrier), whether or not you had disease in one or both of your breasts prior to mastectomy, and the type of reconstruction you had.
It would be best to discuss this...
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Screening of reconstructed breast
The answer varies amongst oncologists. If you have had a mastectomy and reconstruction, then there is no need for a mammogram after reconstruction. However, I have seen oncologists perform MRIs or PETs scan for routine cancer surveillance every 6-12 months post mastectomy and reconstruction. Of course, all this varies based on your tumor biology.
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Radiographic screening after mastectomy
This depends upon many factors including tumor type, oncotype, cancer staging, etc. The decision is made typically by your oncologist. If you have had a unilateral mastectomy, then screening absolutely continues on the contralateral breast.
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MRI Question should Be Decided By Oncologist
In reality, your oncologist should make this decision, based on your initial staging, treatment, etc. The higher your stage, the more likely they will want to follow you every 6 months as opposed to every year or every other year for some women. I would contact your oncologist and see what they recommend, since they are the ones who really understand the risks associated with recurrence levels at different stages, which is what you are really looking for. I hope this helps....
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Yearly MRI after mastectomy depends on several conditions
To some degree, it depends on the type of mastectomy performed and the results of the pathology. If a subtotal or subcutaneous mastectomy is performed or there is suspicion for residual or locally metastatic disease, a yearly MRI may not be unreasonable.
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Post- Mastectomy Follow Up
Breast cancer follow up depends on the type of cancer, its stage, the treatment(s) and what your insurance company considers proper and therefore willing to pay for.
There is little doubt that MRI is a great imaging modality. But it is expensive and I doubt that all insurance companies would be willing to bear its annual cost.
I would advise you to discuss your needs and options with both your surgeon and and your oncologist.
Good luck.
Dr. Aldea
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Breast cancer follow-up
Your question should be best answered by your cancer specialist and is based on many factors. Your body has shown that it knows how to make breast cancer and you are at higher risk on the other side than the general population. Ask your doctor their advice. Finally, congratulations and I hope you have years and years of great health!
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Congratulations on being a survivor!
You will need to continue screening exams on your opposite breast, assuming you only had one removed for cancer. Your breast surgeon will be able to guide you regarding the timing of these exams, as some of the guidelines will be based on the type of cancer you had.
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