Undergoing a mastectomy does not eliminate need for future breast imaging, biopsy

Many breast cancer patients choose a mastectomy over breast conservation therapy so that they no longer need to worry about future screening or a biopsy. However, according to new research published in the Annals of Surgical Oncology, up to 15.5 percent of patients who undergo a unilateral or bilateral mastectomy still require breast imaging later in life. In addition, up to 8 percent of those patients end up undergoing a biopsy of the remaining breast tissue.

“Autonomy and choice in treatment are encouraged, and can be empowering for patients,” lead author Soojin Ahn, MD, assistant professor of breast surgery at Mount Sinai St. Luke’s in New York City, said in a prepared statement. “But decision-making can also result in anxiety, fear, and distress. Some patients might choose more extensive surgery with the hope that this will reduce the need for breast imaging and biopsy later, when in fact this is not necessarily the medically beneficial course.”

The authors studied data from 185 unilateral mastectomy cases and 200 bilateral mastectomy cases performed on breast cancer patients between 2009 and 2015. Follow-up varied from 3 to 75 months, with an average follow-up period of 30 months. Overall, 10 to 15.5 percent of patients still required additional breast imaging later in life, and 6 to 8 percent still required a biopsy. However, the authors added, malignancy in these instances was just 1 percent.

“This information is critical for patient understanding and decision-making,” Elisa Port, MD, chief of breast surgery and co-director of the Mount Sinai Dubin Breast Center in New York City, said in the same statement. “Physicians and their patients should make their surgical treatment decisions after careful consideration of various clinical factors and realistic expectations for post-operative follow up.”