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Mammogram Shown To Be Most Effective 12 Months After Radiotherapy

By MedImaging International staff writers
Posted on 22 Dec 2008

Breast cancer patients who receive breast-conserving therapy and radiation do not require a follow-up mammogram until 12 months after radiation, despite current guidelines that recommend follow-up mammograms at between 6 and 12 months after radiation.

Many women diagnosed with breast cancer will choose to undergo a lumpectomy and radiation therapy as their course of treatment, which has been shown to produce similar survival outcomes to a mastectomy. Mammography has been established as a vital part of post-treatment surveillance for patients undergoing breast-conserving therapy, but the optimal timing of the initial mammogram is not clear.

Researchers from the departments of radiation oncology, pathology, and radiology at the University of California, San Diego (UCSD; USA), School of Medicine tried to determine if the recommended timeframe for a post-treatment mammogram offers any benefit to patients and published their findings November 15, 2008, study in the International Journal of Radiation Oncology Biology Physics.

The most recent U.S. National Comprehensive Cancer Network (NCCN) guidelines proposes a follow-up mammogram 6 to 12 months after radiation, and according to 2006 guidelines, the American Society of Clinical Oncology (ASCO) recommends a follow-up mammogram one year after the first mammogram that leads to diagnosis, but no earlier than 6 months after radiation. Accounting for the time after the initial diagnostic mammogram to have a biopsy, surgery, and radiation therapy, following the ASCO guidelines would likely result in mammograms being performed six to nine months after the completion of radiation.

The researchers evaluated 408 patients who were treated with breast-conserving therapy and radiation between 1995 and 2005 and who had follow-up mammograms at UCSD within one year after completing radiation. The median interval between radiation and the initial mammogram was 3.1 months. Ten patients had suspicious findings on their mammograms, and of those, only two were found to have recurrent cancer. Both of the cases were noninvasive ductal carcinomas.

The cost of a mammogram is approximately US$115, and many women can experience moderate to severe pain during the procedure and high levels of anxiety during a needle biopsy. The researchers determined that because only 0.49 recurrences were detected per 100 mammograms and only noninvasive ductal carcinoma was found, mammograms should not be performed until at least one year after radiation to avoid the medical and psychological costs associated with mammography.

"Omitting the initial post-radiotherapy examination may improve the psychological well-being of patients, especially for women who have already been shown to have breast cancer,” Kevin Lin, M.D., lead author of the study and a radiation oncologist at Advanced Oncology Center (West Covina, CC, USA), said.

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66 (62.942504882812): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (31.948089599609): SELECT fid FROM jos_deeppockets WHERE id=294721469 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294721469 AND published='1' LIMIT 1

69 (31.948089599609): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (326.87187194824): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (220.06034851074): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (42.915344238281): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (51.021575927734): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (35.04753112793): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (36.001205444336): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

105 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

106 (50.067901611328): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (49.829483032227): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

109 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

110 (46.968460083008): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294721469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (614.88151550293): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294721469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (559.09156799316): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (379.08554077148): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

115 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

116 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

117 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

118 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

119 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

120 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

121 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

122 (245.09429931641): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 19176.959991455): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (509.02366638184): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721469 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721469 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7024.0497589111): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (91.075897216797): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (46.014785766602): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (51.975250244141): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (279.90341186523): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (37.908554077148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (32.186508178711): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (28.133392333984): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (455.14106750488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (352.14424133301): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (37.908554077148): SELECT name FROM jos_deeppockets WHERE id=211

138 (31.948089599609): SELECT name FROM jos_deeppockets WHERE id=211

139 (548.8395690918): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (432.01446533203): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

142 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

143 (!!!!! 7544.994354248): TRUNCATE TABLE jos_trademed_module

144 (97.036361694336): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (56.028366088867): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (767.94624328613): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

149 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

150 (!!!!! 1090.0497436523): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (58.174133300781): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

152 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

153 (31.948089599609): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721469 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721469 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (30.994415283203): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

155 (26.941299438477): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (29.087066650391): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (65.803527832031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

158 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721469 AND published='1' LIMIT 1

159 (35.04753112793): select jos_twitters.link from jos_twitters where cat=10

160 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

161 (34.093856811523): select jos_google_plus.link from jos_google_plus where cat=10

162 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

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