Routine mammograms offer limited benefit after double mastectomy
New research suggests that routine breast imaging may provide limited benefit for women who undergo bilateral mastectomy to treat ductal carcinoma in situ.
According to the study, most recurrences in this demographic are identified either after symptoms develop or when clinicians detect concerning changes. The findings suggest that routine screening may have a limited role after the surgery, as little breast tissue remains and the risk of recurrence is low.
“Our findings raise an important question about the value of continued screening after cancer treatment for women with DCIS,” Nimmi Kapoor, MD, an associate professor of surgery at the David Geffen School of Medicine at UCLA and senior author of the study, said in a news release on the findings. “This highlights the importance of appropriate clinical follow-up and making sure patients and their physicians know what changes to look for.”
The study, published in Surgical Oncology Insight, examined post-surgical imaging practices and cancer recurrence detection among 90 women who underwent bilateral mastectomy for ductal carcinoma in situ between 2017 and 2019. Patients were followed for a median of nearly six years. Half received at least one mammogram, ultrasound or MRI after surgery, accounting for 154 imaging exams.
Twelve exams led to biopsies in nine patients; eight biopsies were benign, while four confirmed cancer recurrence. Only one of the four recurrences was detected through routine screening in a patient without symptoms. The other three were identified after patients developed symptoms or clinicians observed concerning changes, including lumps, swelling and breast pain, prompting diagnostic imaging.
Researchers also found no consistent association between post-mastectomy imaging use and patient characteristics such as age, genetic risk, tumor size or tumor type. Primary care and OB-GYN physicians ordered nearly half of all imaging exams and 60% of routine screening tests, suggesting that follow-up practices may vary across providers and that clearer guidance could help standardize care.
Although unnecessary imaging can lead to false-positives, additional biopsies, increased costs and patient anxiety without improving cancer detection, the authors emphasized that their findings do not support discontinuing clinical follow-up. Patients should keep receiving regular evaluations and undergo diagnostic imaging when new or concerning symptoms arise.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.