I attended hospital on Friday for my first follow up appointment (13months after DX)- i was absolutely shocked to find out i won’t be having another mammogram until Dec this yr. I was told lumpectomy ladies were annually and MX ladies were every 2 yrs. I “get” the reasons for annual in the case of lumpectomy but feel disadvantaged that i don’t get the chance to have the other breast checked.
First question - Is it a Scottish thing? or an NHS Lanarkshire thing?
Some ladies told me to refer to the NICE guidelines - i did, though the Breast Cancer Care resource pack says that Nice only covers England & Wales. Anyway, here’s what it says:
Section 9 of “Early and locally advanced breast cancer: diagnosis and treatment” nice.org.uk/nicemedia/live/12132/43413/43413.pdf suggests a 5 year follow-up, that the risk of recurrence in a conserved breast is 0.5 to 1% p/a and that mammography is most likely to detect recurrence in the conserved breast, but is not effective at detecting skin or chest wall recurrence following mastectomy. It also states that the increased risk of a primary cancer in the other breast is just under 0.3% p/a. The recommendation in this document is to offer annual mammography to all patients with early breast cancer until they enter the NHSBSP.
Page 58 et seq of “Improving Outcomes in Breast Cancer Manual Update” nice.org.uk/nicemedia/live/10887/28763/28763.pdf says that follow-up should be targetted at detecting local recurrence, and that after 3 years, followup should be ceased. It says that networks should agree evidence-based policy on the freqency of mammography for women who have been treated for breast cancer.
Lanarkshire NHS seem to have agreed to provide bi-annual mammograms in the case of monitoring the contralateral breast in MX patients, with annual mammograms in the case of local excision. This may be related to the reduced risk per annum of recurrence in MX patients (0.3% p/a) compared to local excision patients (0.3% + 0.5 to 1% = 0.8 to 1.3%).
Any thoughts / suggestions ladies, i didn’t get anywhere with a follow up phone-call to the BCN. Anyone else had this experience.? Much appreciated
Lynn