Mammography in patients with breast cancer treated by breast conservation (lumpectomy with or without radiation)

The woman with breast cancer who undergoes breast-conserving treatment (lumpectomy with or without radiation) is a challenge for the mammographer. The preoperative mammograms of women undergoing breast-conserving treatment, unlike those of women who will be treated by mastectomy, must be evaluated for the extent of tumor to determine if limited surgery can be done with good cosmetic results. In some cases, postoperative mammographic assessment of the breast is done to determine whether any residual tumor exists in the breast. Finally, there is the long-term follow-up of the treated breast to detect any new or recurrent cancer as early as possible. These tasks require knowledge of the mammographic patterns of breast cancer and scar formation, an appreciation of the alterations that occur in the mammogram after breast irradiation, and an understanding of the benign changes that can mimic new breast cancer in these women. The purpose of this review is to discuss the role of mammography in the diagnosis and treatment of these women, including recommendations for when to obtain mammograms, and to present the spectrum of findings that may occur.