Why are mammograms or x-ray not recommended for follow-up (see details)?

Question

Had bilateral mastectomy (for DCIS) with reconstruction so fat & muscles are in chest/breast area, MAMMOGRAMS OR X-RAYS NOT RECOMMENDED, WHY?
There was no invasion into lymph nodes.
[mammograms are recommended when one has a breast implant so why not after having a reconstruction with ones own body tissue?]

Answer 1

Since you were diagnosed with DCIS and chose to have a bilateral mastectomy with reconstruction there is nothing really for the physician to see under mammography.

The purpose of mammography is to be able to visualize the breast tissue with an xray beam. Since a surgeon went into your chest cavity and removed all of the breast tissue and extended it to the chest wall cavity, there technically is no more breast tissue. Granted with reconstruction, the physician was able to recreate these areas with tissues from other areas in your body to give you breasts, but the tissue is inherently different at a cellular level.

Part of the reason for choosing the option of bilateral mastectomy is for the extreme reduction in your chances of recurrence. With mastectomy in DCIS, your chances are in the 98-99% range that you will be cancer free after 5 years. The best thing to do for an annual check is to go in to your physicians office and have them give you a physical exam. The only other thing that they might be able to do is order a routine CT-PET scan to see if there is any uptake in any of the other areas in your body.

Answer 2

If you have had a double mastectomy, you would no longer have any mammary tissue, despite the fact that you have had a reconstruction.

Hense mammograms are superfluous as they are only for checking mammary tissue.

It would be a bit like someone with a full hysterectomy, which removes the cervix, having a pap smear to detect cervical cancer.

Or a woman being tested for testicular cancer.

Some cancers are tissue specific, as are teh tests to detect them. If you don't have the tissue, you don't need the test.

Answer 3

If I understand you correctly you no longer have any breast tissue therefore you are no longer at risk of breast cancer. When a person has breast augmentation (just to increase the size of the breasts) they retain breast tissue as well. As they have breast tissue, they need mammograms.