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Mammography can be reduced for some breast cancer survivors, finds WMS study

Mammography for some breast cancer survivors could be reduced, according to research led by Warwick Medical School’s Clinical Trials Unit.


Currently, annual mammography is recommended by the NHS each year for the first five years following surgery to remove early-stage breast cancer, followed by screening every three years. In the US and Europe, annual mammography is recommended indefinitely.

The Mammo-50 trial, funded by the National Institute for Health and Care Research Health Technology Assessment Programme and sponsored by University Hospitals Coventry and Warwickshire NHS Trust, aimed to establish whether such frequent screening was necessary to improve outcomes.

The team enrolled 5,235 women who had undergone curative surgery to remove their cancer, were free of recurrence three years post-surgery, and were 50 years or older at the time of diagnosis. Participants were randomly assigned to receive annual mammography or less-frequent mammography (every two years for patients who had undergone breast conservation surgery and every three years for patients who had had a mastectomy). 

After five years of follow-up, the breast cancer-specific survival rate was 98.1% and the overall survival rate was 94.7% among patients in the annual mammography group. For patients receiving less frequent mammography, the breast cancer-specific survival rate was 98.3%, and the overall survival rate was 94.5%. At five years, 5.9% of patients in the annual mammography group had experienced a recurrence, compared to 5.5% of patients in the de-escalation group. These results show that less mammography did not worsen the outcomes for the patients.

Professor Janet Dunn from WMS led the study. She says: “De-escalation of mammographic surveillance reduces the burden on the health care system, decreases the inconvenience for women having to undergo these mammograms, and reduces the associated stress of waiting for results.”

Mr Peter Donnelly, surgical lead investigator, says: “Mammography remains a key part of breast cancer survivorship, which includes confidence in self-examination, healthy life-style, adherence to hormone blocking therapy and easy access to professional support.”

Professor Andy Evans, radiological lead investigator, says: “The reduction in mammograms has a substantial impact on radiological services. The results of the trial should be implemented into clinical practice as there is no reason to continue to perform annual mammograms for these patients."

Margaret Grayson, independent patient on the oversight committee and member of Independent Cancer Patients’ Voice, says: “This is great news for patients as it reduces the visits to hospital and scans needed whilst still monitoring patients in an optimal way.”

Find out more about the trial.