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Early detection of breast cancer the second time around: mammography in women with a personal history of breast cancer

Nehmat Houssami and Diana L Miglioretti
Med J Aust 2011; 194 (9): 439-440.

Australian and US collaborators provide evidence on outcomes of mammographic screening in previously affected women

Women with a personal history of breast cancer (PHBC) represent an increasing group of cancer survivors, and have a lifelong increased risk of developing a new or recurrent cancer in the conserved (ipsilateral) breast, or a contralateral cancer. The risk of a “second” breast cancer in women with PHBC has been estimated at 5.4 to 6.6/1000 woman-years.1 Evidence of screening benefit in PHBC women comes from observational studies2-4 and extrapolation of benefit from randomised mammographic screening trials; consensus-based recommendations include annual mammography in routine surveillance of PHBC women.5-7 Early detection may also minimise the physical and psychosocial burden and consequences of a second breast cancer. Evidence reviews have consistently acknowledged the lack of quality data on mammographic screening in PHBC women,4,8 and research into screening high-risk women has mostly focused on those with breast and ovarian cancer susceptibility genes; evaluation of screening in women with PHBC has received relatively little attention.4,8

  • Nehmat Houssami1
  • Diana L Miglioretti2,3

  • 1 Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW.
  • 2 Biostatistics Unit, Group Health Research Institute, Seattle, Wash, USA.
  • 3 Department of Biostatistics, University of Washington, Seattle, Wash, USA.

Correspondence: nehmath@med.usyd.edu.au

Acknowledgements: 

We thank the Breast Cancer Surveillance Consortium investigators for supporting the research discussed in this editorial. Procedures for requesting Breast Cancer Surveillance Consortium data for research purposes are provided at http://breastscreening.cancer.gov. Nehmat Houssami receives support from National Health and Medical Research Council program grant 633003 to the Screening and Test Evaluation Program.

Competing interests:

We had prominent roles in the design, conduct and publication of the study discussed in this editorial.9

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