Importance of long-term monitoring of patients with breast reconstructions: a case of 10-year cancer recurrence

Figures & data

Figure 1. Clinical photographs of the AP, right lateral and left oblique views of the patient before salvage surgery (a, d, g), after the DIEP flap (b, e, h) and after fat grafting (c, f, i) to the volume deficit and the contour deficiency especially in the take-off superiorly.

Table 1. International guidance from major regulatory bodies in the US, UK, and Europe on recommended post-operative clinical and radiological examination frequency mastectomy for breast cancer.

Guideline	History and clinical examination	Imaging onset: screening mammogram	Imaging frequency	Imaging frequency reduction and termination
ACR [19]	No recommendation	Contralateral 6–12 months post radiotherapy	Annual	Institutions to decide when to return to routine breast cancer screening
ACS-ASCO [20]	3–6 Months for first 3 years, Every 6–12 months for years 4–5, then annually	Contralateral >6 months post radiotherapy	Repeat every 6–12 months and reduce to annual if MMG stable	No recommendation
ESMO [21]	Every 3–4 months for first 2 years, Every 6 months years 3–5, then annually	Contralateral: onset timing not specified	Annual	No recommendation
NICE [17]	Regular follow up appointments as stipulated by physician or patient	Not specified	Annual	After 5 years if >/= NHS BSP screening age, frequency thereafter not specified
NCCN [22]	4–6 Months for first 5 years then annually	Contralateral 6–12 months after RT	Annual	No recommendation
RCR [18]	Not specified	Contralateral: onset not specified. Ipsilateral if high risk and recipient of autologous tissue reconstruction	Annual	Consider reduced frequency age 50 and cessation age 75

Abbreviations: ACR: American College of Radiologists; ACS: American Cancer Society; ASCO: American Society of Clinical Oncology; ESMO: European Society of Medical Oncology; NICE: National Institute of Clinical Excellence; NHS BSP: National Health Service Breast Screening Programme; NCCN: National Comprehensive Cancer Network; RCR: Royal College of Radiologists.

:Mainiero MB, Moy L, Baron P, Expert Panel on Breast Imaging, et al. ACR appropriateness criteria® breast cancer screening. J Am Coll Radiol. 2017;14(11S):S383–S390.

 PubMedGoogle Scholar

Runowicz CD, Leach CR, Henry NL, et al. American Cancer Society/American Society of clinical oncology breast cancer survivorship care guideline. CA Cancer J Clin. 2016;66(1):43–73.

 PubMed Web of Science ®Google Scholar

Senkus E, Kyriakides S, Ohno S, et al. Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26(Suppl 5):v8–v30.

 PubMedGoogle Scholar

National Institute for Health and Care Excellence (NICE). 2017. NICE clinical guideline 164 [CG164]: familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer. National Institute for Health and Care Excellence (NICE), Manchester. https://www.nice.org.uk/guidance/cg164.

 Google Scholar

Gradishar WJ, Anderson BO, Abraham J, et al. Breast cancer, version 3.2020, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2020;18(4):452–478.

 PubMedGoogle Scholar

The Royal College of Radiologists. Guidance on screening and symptomatic breast imaging. Fourth edition. London: The Royal College of Radiologists; 2019.

 Google Scholar