Frequency of post-treatment mammograms?

Raili

I'm not even done with radiation yet, so I don't know why I'm already worrying about this, but...

How frequently does one "need" to have mammograms once active treatment for breast cancer is complete?  What factors does it depend upon?  Patient age, cancer stage or type or size, differing hospital's policies, or...?

I'm supposed to have a 6-month follow-up with my surgeon - that is, 6 months after my surgery - but she didn't say exactly what that appointment would be for.  And I'm wondering if a mammogram will be part of it.  I'm only 31 and have dense breasts and I'm resistant to the idea of being exposed to the mammography radiation too frequently or too soon after all this radiation I'm going through now!

I'm thinking of saying no to mammograms, or just getting one every couple of years, and relying more on regular MRIs, ultrasounds, thermograms, and breast exams (both self-exams and from my doctor).  What do you think?

YramAL

I just saw my oncologist today for my first post-radiation check up, and he told me that the schedule for mammograms is 6 months after lumpectomy for my affected breast only, then both breasts after a year. I'm not sure what the schedule is after that.

I do not have dense breasts but I know that my oncologist pushes for MRI's for women with dense breasts.

Mary 

ruthbru

I did every six months on the 'bad' boob for the first two years (the usual yearly for the 'good' boob); and now am back on a once a year schedule for 'the girls'. 

geebung

I have ambivalent feelings about mammograms. I had yearly mammos (and ultrasounds) through my 40s due to minor problems like cysts, discharges etc - I guess you would say I had "busy" breasts?  I turned 50 and my yearly mammogram showed DCIS. It turned out to be extensive and high grade, requiring a mastecomy. Ever since my dx, I have wondered if the yearly radiation of the mammos contributed to my DCIS. It probably did...but if I hadn't had that mammogram where would I be now? It wasn't a low-grade, small area of DCIS and my BS said that he was certain it would have become invasive if it hadn't been discovered and treated when it was. That was 3 years ago and I have been gradually increasing the time between mammos - I went 16 months between the last 2 in order to decrease the amount of radiation. My BS says I should be having yearly screening. It's my decision to go against his recommendations. I have very mixed feelings about the whole screening thing. I'm thinking of doing thermography as an adjunct to conventional screening.

painterly

I am really concerned about mammograms. I was given my mammogram two months after I finished radiation. When I went for a follow up visit to my radiologist, she "flipped out" when she heard I had had my mammo already.

But nobody told me there was a definite waiting time. The darn surgeon was with me at the reception desk helping me to find an appointment and he knew all my details about post op. treatments. (The surgeon is the founding surgeon of the breast clinic). So I am very worried now and expect a recurrence sometime in the future. My lump was only the size of a pea: 0.6cm with clear margins and the lymph node had an isolated tumour cell. I try to console myself with the fact that I only had 20 days of radiation. I wonder how much radiation is actually in a mammogram.

tweetybird

I was done with rads the middle of November, and had my mamo in February, so that was 3 months out. I had that along with a ultrasound. I've been getting mamo's once a year, and also a MRI, (also with an ultrasound) these are spaced out every 6 months. So there's my mamo and ultrasound in February, and MRI/ultrasound in August.

Trickling

With Stage IV members' indulgence, I posted a comments about mammograms on the similar topic under Stage IV.  I probably should be posting here as I am NOT Stage IV. Since I don't think I should copy/paste my comment, I invite you to see my comment(s) there.  However, if anyone wishes to chime in, please use the topic, here: "FREQUENCY of post-treatment mammograms."

geebung I'm glad you also shared your take on this topic.

Leah_S

painterly, as I understand it, they usually like to wait to do a mammo after rads because the mammo can cause something called "radiation recall", which means that the skin on the radiated breast reacts the way it did during treatment - redness, pain, etc. The mammo itself can also be extremely painful if the breast is still tender from rads.

I had a mast, and three months after I finished rads I went for a mammo and u/s on the boob side and an u/s on the noboob side. The receptionist wasn't sure if I should get a mammo that day, she kept telling me they always wait 6 months minimum after rads. I asked her to check so she did and came back very embarassed and said, "Um, the mammo is not where you had rads". Yeah, lady, I knew that.  Sweet but dumb.

Leah

flash

bumped up to get the troll and spam off the lead post.

Mouser

 Here's one calculation of the risk of mammograms, from http://www.hps.org/publicinformation/ate/q4720.html

".... the National Council of Radiation Protection and Measurements estimates that the risk of a fatal cancer and additional nonfatal cancer is 0.06/Sv. Some calculations result in a fatal cancer risk of 0.6 per 10,000 person-mSv. That is, if 10,000 persons receive 1 mSv each, there will be 0.6 additional cancers, or 0.24 additional cancer deaths if 10,000 people each receive 0.4 mSv.

The American Cancer Society reports that the average risk of developing cancer is about one in three for females during their lifetimes, or 38.18 percent. (edited to say -- that's the risk of *all* cancers, not just bc). Adding the additional 0.24 cancers due to 0.4 mSv to the natural risk of 3,818 cancers in 10,000 would correspond to an increase of 0.006 percent in the natural cancer incidence rate, which is really an inconsequential increase."
Steven H. King, CHP, CMHP
John P. Jacobus, MS, CHP"

Keep in mind that this is from the ACS, which probably encourages mammograms, and it only talks about 1 mammogram, not repeated over decades. But it fits with data i give my class on relative exposures due to various medical procedures. I opted out of a test for reflux (barium upper GI) this summer because i thought the info provided wasn't worth the dose i would get. And i'm still kicking myself for agreeing to a CT-scan that i knew was unnecessary (miscommunication with the doctor) that of course led to a follow-up.... But i must say - dental X-rays and yearly mammograms are not on my worry list. The risk/benefit calculation is in favor of having them, in my opinion.