Clinical impact of follow‐up imaging on mortality in Korean breast cancer patients: A national cohort study

• Published in: Cancer medicine (Malden, MA) MA), 2021-09, Vol.10 (18), p.6480-6491
• Main Authors: Jung, So‐Youn, Kim, Young Ae, Lee, Dong‐Eun, Joo, Jungnam, Back, Joung Hwan, Kong, Sun‐Young, Lee, Eun Sook
• Format: Article
• Language: English
• Subjects: Adult; Aftercare - methods; Aftercare - statistics & numerical data; Aged; Bone imaging; Bone surgery; Breast - diagnostic imaging; Breast - pathology; Breast - surgery; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Cancer Prevention; Cancer surgery; Cancer therapies; Chemotherapy; Chemotherapy, Adjuvant - statistics & numerical data; Chest; Clinical outcomes; Cohort analysis; Comorbidity; Computed tomography; Female; Follow-Up Studies; follow‐up; Humans; Incidence; Magnetic Resonance Imaging; Mammography; Mammography - standards; Mammography - statistics & numerical data; Mastectomy; Metastases; Metastasis; Middle Aged; Mortality; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - prevention & control; Patients; Positron Emission Tomography Computed Tomography - statistics & numerical data; Practice Guidelines as Topic; Radiation therapy; Radiography; Radiotherapy, Adjuvant - statistics & numerical data; Republic of Korea - epidemiology; Scintigraphy; surgery; surveillance; survivors; Tomography; Tomography, X-Ray Computed; Watchful Waiting - methods; Watchful Waiting - standards; Watchful Waiting - statistics & numerical data
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.3873

Background As the incidence of breast cancer has increased and the survival rate has improved, supporting the optimal follow‐up strategy has become an important issue. This study aimed to evaluate follow‐up imaging usage after breast cancer surgery and the implications on mortality in Korea. Methods This study included 96,575 breast cancer patients diagnosed during 2002–2010 and registered in the Korea Central Cancer Registry, Statistics Korea, and Korean National Health Insurance Service. We evaluated the frequency of breast imaging (mammography and breast MRI) and systemic imaging for evaluating the presence of distant metastasis (chest CT, bone scan, and PET‐CT), and performed analyses to determine if they had an effect on mortality. Results The median follow‐up period was 72.9 months (range: 12.0–133.3) and 7.5% of the patients died. Among all patients, 54.7%, 16.2%, 45.6%, and 8.5% received 3 or more mammograms, chest CTs, bone scans, and PET‐CTs within 3 years after surgery, respectively. Among patients who developed recurrence after 3 or more years, a comparison of overall mortality and breast‐cancer specific mortality according to the frequency of imaging by modality (