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Old 04-30-2010, 11:50 AM   #1
Lani
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Radiologic conference--semiannual mammograms being recommended to post-lumpectomy,

radiation therapy bc patients


Post-Lumpectomy Patients May Benefit From Semiannual Mammograms, Study Suggests

Semiannual mammographic surveillance (every six months) of women who receive post-breast conservation therapy (or “lumpectomy”) for the treatment of breast cancer allows physicians to detect recurrences at an earlier stage, potentially saving the lives of some women, according to a study to be presented at the ARRS 2010 Annual Meeting in San Diego, CA.

A lumpectomy is the standard of care for treating women with early stage breast cancer. It is proven to be just as effective as a mastectomy, but much less invasive. “Unfortunately, neither approach cures all women,” said the authors of the study.

About 10-20 percent of women will go on to develop a recurrence of the first tumor or a new second primary cancer after a lumpectomy. “Those with a recurrence or a new second primary cancer have up to a 300 percent increased risk of dying from it. Thus, adequate surveillance for recurrence through mammography and clinical exam is important,” said the authors. However, most institutions monitor these women yearly and this may be too conservative because cancer organizations also currently recommend screening low-risk women from the general population every year.

“Our study, performed at the University of California, San Francisco, included 7,140 exams that were compliant with our semiannual protocol and 1,065 that were considered to represent annual follow-up. Cancers identified at semiannual surveillance were less advanced than those identified during annual surveillance. Invasive cancers identified at semiannual surveillance also tended to be smaller and lymph-node negative,” said the authors.

“Our study is the first to provide hard evidence that there may be a benefit to semiannual screening of post-lumpectomy patients. Semiannual surveillance detects recurrences at an earlier stage, when the tumor is more likely smaller and has yet to spread to the adjacent lymph nodes, which can increase ones chance of survival,” said the authors.

This study will be presented on Tuesday, May 4, at 2:50 p.m. Pacific Time. For a copy of the abstract or to schedule an interview with one of the study authors, please contact Heather Curry via E-MAIL at hcurry@acr-arrs.org.

About ARRS

The American Roentgen Ray Society (ARRS) was founded in 1900 and is the oldest radiology society in the United States. Its monthly journal, the American Journal of Roentgenology, began publication in 1906. Radiologists from all over the world attend the ARRS annual meeting to participate in instructional courses, scientific paper presentations and scientific and commercial exhibits related to the field of radiology. The Society is named after the first Nobel Laureate in Physics, Wilhelm Röentgen, who discovered the x-ray in 1895.

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Old 04-30-2010, 12:38 PM   #2
Becky
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Re: Radiologic conference--semiannual mammograms being recommended to post-lumpectomy

I wonder for how long they want mammos 2x a year. I had lumpectomy and had mammos 2x a year for the first two years but after that, it became annual.

The article doesn't say how long they are recommending semi annual.
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Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 04-30-2010, 06:29 PM   #3
Gerri
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Re: Radiologic conference--semiannual mammograms being recommended to post-lumpectomy

Becky,

Do I remember correctly that you also get a yearly MRI, alternating every six months with the mammo? I was on the same schedule but just saw my surgeon yesterday and he wants to drop the mammo and just do a yearly MRI. He said that MRIs are more accurate and having a mammo too exposes me to unneccesary radiation. This study does not seem to factor MRIs into the mix but I wonder if I should ask him to reconsider.
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Gerri
Dx: 11/23/05, Lumpectomy 12/12/05
Tumor 2.2 cm, Stage II, Grade 3, Sentinel Node biopsy negative
ER+ (30%) /PR+ (50%), HER2+++
AC X 4 dose dense, Taxol X 4 dose dense
Herceptin started with 2nd Taxol, given weekly until chemo done
then given every 3 weeks for one year ending on March 16, 2007
Radiation 30 treatments
Tamoxifen - 2 yrs (pre-menopausal)
May 2008 - Feb 2012 Femara
Aug 2008 - Feb 2012 Zometa every 6 months
March 2012 - Stop Femara, now Evista for bone strengthening
**********
Enjoy the little things, for one day you may look
back and realize they were the big things.
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Old 05-01-2010, 10:31 PM   #4
Jean
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Re: Radiologic conference--semiannual mammograms being recommended to post-lumpectomy

I alternate every six months between mammo and MRI - have been doing since lumpectomy 2005.

I intend to continue to do. So far my gut instincts have served me well. I feel this way - while mammo is an important tool - by alternating with MRI you have additional opportunity to catch a cancer in the early stage.
For me this program is part of my breast health care program.

A mammo has an average of 70 millirems, roughly the dose you'd receive from your normal everyday environment over a period of 2 1/5 months. Studies have shown no increase risk of cancer among people experiencing as many 1,000 millirems per year of background radiation. Cetainly we don't want to exposure our bodies if we don't need to.
Interesting factor is breast tissue is somewhat unusual, since the rate of cell turnover varies with the amount of estrogen. As a result, the breasts are much less susceptible to radiation among post menopausal women.
Each day we are exposed to small amounts of background radiation. For instance a flight from NY to Chicago will expose you to 39 millirems of radiaiton. So I cut down my flying and use my millirems in my yrly mammo....(just kidding). But we have to make health choices.

Jean
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Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
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9/06 Completed chemo
Started Femara Sept. 2006

Last edited by Jean; 05-01-2010 at 11:00 PM..
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Old 05-01-2010, 10:39 PM   #5
mcgle
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Re: Radiologic conference--semiannual mammograms being recommended to post-lumpectomy

Here in the UK, you get yearly mammograms up to five years from dx; thereafter it is every two years, and when the magic 10 years is up, it is back to the mobile NHS van!

MRIs are considered very expensive for the bog standard, non-private patient.

Mcgle (UK)
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Old 05-02-2010, 11:49 AM   #6
StephN
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Re: Radiologic conference--semiannual mammograms being recommended to post-lumpectomy

I had the same as Becky. Twice yearly mammos for the first 2 years post lumpectomy, than on to annual.

I did get breast MRI's as part of a trial at the end of 2000 prior to my lumpectomy. Was called Rodeo MRI.

Had a couple MRI's since then to look at some odd places that turned out to be nothing.

The mammos I have been getting for the past few years are "digital."
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"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 05-02-2010, 03:49 PM   #7
tricia keegan
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Re: Radiologic conference--semiannual mammograms being recommended to post-lumpectomy

I get digital mammo's yearly and have done since my diagnosis in '05.

I personally feel I'd welcome a yearly full body scan (without reporting symptoms) as routine but really would'nt want a mammo twice yearly.

A local recurrance would'nt worry me too much but a distant one would!!!
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Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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Old 05-04-2010, 06:47 AM   #8
Jean
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Re: Radiologic conference--semiannual mammograms being recommended to post-lumpectomy

These articles just released -

http://www.medicalnewstoday.com/articles/187164.php

http://www.medicalnewstoday.com/articles/187173.php


The above articles support the need for alternate checking every 6 months.

jean
__________________
Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
Started Femara Sept. 2006
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Old 05-04-2010, 10:58 AM   #9
StephN
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Wink Re: Radiologic conference--semiannual mammograms being recommended to post-lumpectomy

And DON'T FORGET your frequent SELF CHECKS as part of that overall surveillance routine.
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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