Current State of Evidence-Based Long-Term Monitoring Protocols for Breast Plastic Surgery Patients

Overview

Journal Ann Surg Oncol

Publisher Springer

Specialty Oncology

Date 2024 Aug 5

PMID 39103688

Authors

Isabel W Ho

Anna Chichura

Holly J Pederson

Brian A Xavier

Julie Ritner

Graham S Schwarz

Affiliations

Soon will be listed here.

Abstract

Background: Recommendations for breast surveillance following breast plastic surgery are frequently changing. Establishing guidelines for long-term monitoring protocols may help identify treatable conditions and prevent untoward sequelae. We sought to evaluate the current state of evidence-based long-term monitoring protocols for patients following breast augmentation, reduction, and breast reconstruction.

Methods: Official guidelines from various American societies and international societies were analyzed for alignment in evidence-based recommendations regarding breast surveillance.

Results: The most recent US FDA update recommends magnetic resonance imaging or ultrasound starting 5-6 years after surgery and every 2-3 years thereafter. Discrepancies exist among professional societies: the American Society of Plastic Surgeons (ASPS) aligns with the FDA, while the American Society of Breast Surgeons and American College of Radiology (ACR) find no role for imaging for asymptomatic cases. Ultrasound is first-line for any implant concerns, with MRI if necessary. European societies oppose routine breast implant imaging. Breast reduction patients lack unique screening protocols; monitoring aligns with age and cancer risk factors. Following mastectomy and breast reconstruction, most organizations advocate for annual clinical examinations, with more frequent examinations initially. Evidence suggests that physical examination is sufficient to detect local cancer recurrence, with imaging only indicated if there is concern for recurrence. No surveillance imaging is recommended by the American Society of Clinical Oncology, National Comprehensive Cancer Network, or ASPS; however, ACR recommends mammography for autologous reconstruction only.

Conclusion: Multispecialty and regulatory body alignment may promote provider and patient adherence. Ongoing studies of long-term outcomes are needed to strengthen the level of evidence for monitoring guidelines.

Citing Articles

Silicone Breast Implant Rupture Triggered by Infection Leading to Skin Ulceration: A Case Report.

Nagata Y, Sezaki S, Kinoshita I, Saeki T, Fujikawa T Cureus. 2025; 16(12):e75556.

PMID: 39803107 PMC: 11723711. DOI: 10.7759/cureus.75556.

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