A survey of UK breast surgeons and radiologists to determine current and aspired mammography surveillance practice after treatment for primary breast cancer

Introduction
There is considerable debate about the optimal organisation of a surveillance mammography service following breast cancer treatment in the UK. The optimal frequency and duration of surveillance mammography is unclear, leading to variation in follow-up protocols. The aim of our survey was to describe the variation in current mammography surveillance practice.

Methods
A web-based, anonymous survey of members of the Association of Breast Surgery (ABS) at the British Association of Surgical Oncology (569) and Royal College of Radiology (RCR) Breast Group (479). Participants were invited to complete the survey via an email-based web-link sent by membership administrators.

Results
The survey was sent to 1,048 members from 106 NHS trusts and 185 (18%) responded: 64 (35%) radiologists, 119 (64%) surgeons, 2 (1%) other. The majority of respondents (158, 85%) initiated surveillance mammography (SM) 12 months after completion of surgery; 140 (76%) conduct SM annually following breast conserving surgery. Following mastectomy most conduct SM annually (103, 56%), or biennially (48, 26%). Most discharge from clinical follow-up at 5 (85, 46%) or 10 years (29, 16%) and from SM follow-up at 5 (45, 24%) or 10 (66, 36%) years. Forty-three percent of respondents followed one of two patterns of surveillance: initiate SM at 12 months, annual SM, with discharge at 5 years (34 of185); or initiate at 12 months, annual SM, with discharge at 10 years (46 of 185). Respondents varied greatly in the combinations of start, frequency, duration and discharge from SM.

Conclusion
Whilst common patterns in surveillance mammography practice exist, there is considerable variation in the way surveillance is organised.