Researchers in Scotland found that mammography examinations improve a breast cancer patient’s chance of survival – they reported the findings of their latest study in Health Technology Assessment 2011; vol. 15:34. Every year approximately 45,000 women in the UK are diagnosed with breast cancer.

Outcomes in breast cancer patients are improving and many women are free of recurrence. Women are receiving regular follow-up appointments for up to 3 years in order to ensure early detection of any recurrences.

Research leader, Professor Fiona Gilbert of the University of Aberdeen stated:

“There is currently debate surrounding the follow-up process in terms of frequency and detection method. Early detection of primary and secondary cancers increases the likelihood of survival, but the frequency that mammographic surveillance should be used is not clear.”

Professor Gilbert and team set out to establish the most efficient and effective method to examine women after breast cancer treatment. The study was measured in terms of safety, efficacy and frequency by conducting two systematic reviews with surveyed breast surgeons and radiologists determining current practice and estimate cost-effectiveness. Patient data was modeled from various sources and included data from the West Midlands Cancer Intelligence Unit Breast Cancer Registry.

Survey results show that although similarities exist, mammographic monitoring is different to other methods in terms of start, duration, frequency and discharge and increases the chances of survival, according to data from systematic reviews, compared to follow-ups that do not include this method. MRIs are the most precise method to detect new metastases.

It is not clear whether combinations of other surveillance methods, such as clinical examination are effective. Patient data indicates that the chance of survival is higher in women with smaller tumors, i.e. less than 10mm in diameter.

In terms of cost-effectiveness, mammographic monitoring was best when provided on a 12-month basis and was most suitable for women who had higher chances of developing a secondary or primary tumor, but more cost-effective in 3-year intervals in those unlikely to develop another growth.

Professor Gilbert concluded:

“The results of our research demonstrate that mammographic surveillance is an effective and cost-effective way of detecting new growths. Our research has the potential to influence the way in which follow up appointments are organized in the future.”

The HTA program welcomes proposals on surveillance regimes following early breast cancer as a result of the questions raised by this research. Application deadline is Thursday 6 October 2011.

Written by Petra Rattue