Nobody understands the importance of regular mammograms more than breast cancer survivors, yet all too often people put off scheduling a mammogram after recovering from cancer care. Part of the reason may be the fact that the last mammogram resulted in devastating news. And there are so many unknowns---for example, whether a mammogram should be taken on the side of a mastectomy, or how reconstruction affects the results of a mammogram. Getting the answers to these questions will put you back in charge of your breast health.
Time Frame
How soon after the completion of your cancer treatment you should have a mammogram is largely up to you and your doctor. Some experts recommend having a baseline mammogram performed at six months, with follow-up screenings done every six months for two to three years. Others feel that annual mammograms, combined with clinical exams, are perfectly adequate. Talk with your doctor to see what is best for you.
After a Mastectomy
Whether or not you need a mammogram on the side(s) where you've undergone a mastectomy depends on the type of mastectomy you've had. Total, modified radical, and radical mastectomies involve the removal of all breast tissue plus the nipple and areola. According to the American Cancer Society, routine mammograms are not necessary after these types of mastectomies. Subcutaneous mastectomies, however, remove the breast tissue but leave the nipple and areola intact. Enough tissue remains in the breast to warrant annual mammograms.
After Reconstruction
After a mastectomy, breasts can be reconstructed using implants, tissue or a combination of the two. A saline or silicone implant is commonly used to rebuild a breast. Mammograms are rarely done in such circumstances because the breast tissue has been removed and the mammogram cannot view the underlying tissue behind the implant. However, if a clinical breast exam reveals a possible concern, a mammogram may be done with additional views.
A tissue reconstruction is one that uses a woman's own tissue from another part of her body, most often from her abdomen or back, to recreate her breast. While mammograms are not usually necessary, there are certain circumstances that would indicate the need, including women at high risk for recurrence, women with very large breasts or breasts that are difficult to examine, and any woman with a breast abnormality. If a combination of implant and tissue is used for reconstruction, women should follow guidelines for both implants and tissue.
After a Lumpectomy
Lumpectomy involves the removal of a tumor, as well as a small area of surrounding tissue. This is typically followed by radiation treatment, which will change the density and texture of the remaining tissue and skin. Your doctor will conduct a new baseline mammogram as early as six months after the completion of radiation therapy, followed by annual screenings. If you had tissue reconstruction after therapy, you will wait to have a mammogram until the tissue has healed.
Considerations
Even if a mammogram is no longer required on one side because the breast has been removed, always schedule your annual mammogram for the unaffected side. Women who have had cancer on one side are at higher risk of developing cancer on the other, according to the American Cancer Society. Scheduling regular mammograms is part of being good to yourself and moving on with your life.
