ORIGINAL CONTRIBUTION Accuracy and Outcomes of Screening Mammography in Women With a Personal History of Early-Stage Breast Cancer

THE HIGH PREVALENCE OF BREAST cancer survivors is due to general gains in life expectancy and to improved survival in women with a personal history of breast cancer (PHBC), attributable to improvements in local and systemic treatments and early detection. Women with PHBC are at risk of developing second breast cancers, which can be ipsilateral (in-breast recurrence or new ipsilateral cancer) or contralateral; risk of a second breast cancer was recently estimated at 5.4 to 6.6 per 1000 womanyears. The consensus is that PHBC women may benefit from early detection of second breast cancers, although evidence of screening benefit in these women comes from nonrandomized studies and extrapolation of benefit from randomized population mammography screening trials. Screening or surveillance mammography (referred to here as screening) is usually recommended by guidelines and consensus recommendations for follow-up of PHBC women. Several reviews have concluded that little quality evidence is available on mammography screening accuracy in Author Affiliations: Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia (Drs Houssami and Irwig); Biostatistics Unit, Group Health Research Institute, Seattle, Washington (Ms Abraham and Dr Miglioretti); Department of Biostatistics (Dr Miglioretti) and Group Health Research Institute and Departments of Epidemiology and Health Services (Dr Buist), University of Washington, Seattle; Department of Radiology (Dr Sickles) and Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs (Dr Kerlikowske), University of California, San Francisco; Departments of Family Medicine and Radiology, University of Vermont, Burlington (Dr Geller); and Department of Medicine, University of North Carolina, Chapel Hill (Dr Muss). Corresponding Author: Nehmat Houssami, MBBS, PhD, Screening and Test Evaluation Program, School of Public Health (A27), Sydney Medical School, University of Sydney, NSW 2006, Australia (nehmath @med.usyd.edu.au). Context Women with a personal history of breast cancer (PHBC) are at risk of developing another breast cancer and are recommended for screening mammography. Few high-quality data exist on screening performance in PHBC women.