Study Leads to New Protocol for Mammography Screening

New data reported by researchers at the Herbert Irving Comprehensive Cancer Center (HICCC) concluded that more frequent mammographic screening among women treated for early-stage breast cancer might not confer additional benefit at the expense of potential harm.

The research, which was presented at the annual meeting of the American Society of Clinical Oncology held May 29-31, was co-led by Katherine D. Crew, MD, member of the HICCC’s Cancer Population Science program, and Julia McGuinness, MD, a hematology and oncology postdoctoral fellow in at Columbia University Irving Medical Center.

“As a result of this data, we’ve modified our mammography screening protocol among breast cancer survivors to reduce the harms of screening,” says Dr. Crew.

Women treated for early-stage breast cancer remain at risk for local recurrence, and the standard guidelines for these patients have been to receive a screening mammogram semiannually (every six months) for two to three years after diagnosis. However, recommendations for optimal screening strategies, note the researchers, are based upon expert consensus opinion rather than data from randomized controlled trials.

Dr. Crew and collaborators examined the relationship between frequency of ipsilateral surveillance and rates of false-positive biopsy and local recurrence among women treated with breast-conserving therapy (BCT), or lumpectomy. The study analyzed mammography screening frequency among over 1400 women with early stage breast cancer at NewYork-Presbyterian/Columbia. It found that women who screened every six months vs. yearly had a two-fold increase in false positive or unnecessary breast biopsies with no difference in detection of local recurrence, suggesting that it is safe for women with early-stage breast cancer to undergo less frequent screenings.

The research team at the HICCC included Richard Ha, MD, and Jeanine Genkinger, PhD, and collaborators at Baylor College of Medicine and NYU Grossman School of Medicine.

“There is a clear need for prospective studies to determine optimal screening strategies among breast cancer survivors,” says Dr. McGuinness.