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Table 3 Recommendations on modalities for breast imaging surveillance

From: Breast imaging surveillance after curative treatment for primary non-metastasised breast cancer in non-high-risk women: a systematic review

Guideline Mammography Ultrasound (CE-)MRI Other
  BCT Mastectomy    
ACR BLa CL Optional, especially for dense breasts Recommended for
- dense breast tissue
- patients diagnosed < 50 years old
DBTa
ACS-ASCO BL CL NR NR NR
ASCO BL NS NR NR NR
AHS BL CL NR NR NR
BCMH-BCMA BL CL NR NR NR
CAR BL NS NS NS NS
CCMB BL CL NR NR NR
DKG-DGGG BL CL If quality-assured, should be added for breasts and axilla May play an additional role in the differentiation of scar vs recurrence NR
ESMO BL CL BL/CL May be indicated for young patients, especially in cases of dense breast tissue and genetic/familial predispositions NRb
GISMa-ICBR/SIRM BL NS NS NR Brief mention of DBT as a supplemental investigation, without further elaboration or recommendation
HAS BL CL May be associated NR NRc
KCE BL NS With or without - Initial BC not seen on other imaging
- Other imaging inconclusive
NR
NABON-KIMS BL CL NS May play an additional role in:
- differentiation scar vs recurrence
- BC not visible on mammography
- autologous breast reconstructions
NR
NBOCC BL CL If indicated on clinical or radiological grounds, including:
- young women
- dense breasts
- initial breast cancer undetectable by mammography
Specific high-risk subgroups NR
NCCN BL CL NR NR NRd
NICE BL CL NR NR NR
NZGG BL NS NS NS NR
RCR BL CLe NR NR NS
  1. NS not specified, NR not recommended, RT radiation therapy, LRT locoregional therapy, BC breast cancer, BCT breast-conserving therapy, DBT digital breast tomosynthesis, IL ipsilateral, CL contralateral, BL bilateral, (CE-)MRI (contrast-enhanced) magnetic resonance imaging. For other abbreviations see Table 1
  2. aDiagnostic digital breast tomosynthesis (DBT) received identical appropriateness score (9/9) and relative radiation level rating (2/3) as diagnostic mammography. For intermediate-risk women, breast mammography or DBT (with accompanying planar or synthesised 2-D images) is recommended
  3. bFor patients who take tamoxifen, an annual gynaecological examination is recommended, possibly with a gynaecological ultrasound
  4. For patients who take an aromatase inhibitor, regular bone density evaluation is recommended
  5. cDepending on the context, following examinations may be indicated: - for patients who take tamoxifen, an annual pelvic ultrasound for excluding endometrial malignancies; - for patients who take an aromatase inhibitor, bone density evaluation every 1–3 years
  6. dMonitoring of bone health with a bone mineral density determination at baseline and periodically thereafter is advised for women on aromatase inhibitors or women who experience ovarian failure secondary to treatment
  7. eAlso ipsilateral, if autologous reconstruction with high recurrence risk