Repeatedly testing women who have had a mastectomy for recurrence of cancer does not significantly extend survival rates, according to new guidelines by the American Society of Clinical Oncology.

The society is basing its revised guidelines on a review of papers published over the past 20 years. They found, for example, that the value of bone scans is severely limited by the high rate up to 90 per cent of false positives, where the cancer was wrongly diagnosed as having returned.

Chest radiography fared even worse. Recurring cancer was detected by this means in only 2.7 per cent of cases.

The guidelines conclude that, although there was some small merit in offering annual mammography of both breasts, examination by a doctor or the woman herself may be the best means of detecting recurrent breast cancer (J Clin Oncol, 1997, 15: 2149-56).

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