Mammograms After Breast Surgery

After surgery for breast cancer, such as a lumpectomy or mastectomy, it’s best to talk with your doctors about which screening tests they recommend for you.

Your healthcare team should monitor you for signs or symptoms that breast cancer has come back (called recurrence) or of a new breast cancer. But how they do this will depend on the type of surgery you had, whether you have remaining breast tissue, and your individual risks.

Getting regular physical exams of the breast (or chest area) is recommended for pretty much everyone who has had breast cancer, regardless of the type of surgery they had.

Guidelines from the American Society of Clinical Oncology (ASCO) recommend meeting with a healthcare provider for a check-up that includes a physical exam after your breast cancer treatment:

• Sponsor Message

  two to four times a year for the first three years after active treatment ends

• Sponsor Message

  one to two times a year for the next two years

• Sponsor Message

  once a year after that 

Your doctors may or may not also recommend getting routine mammograms or other imaging tests, depending on the type of surgery you had.

Learn more about getting good follow-up care after active treatment for early-stage or locally advanced breast cancer, including which tests are typically recommended for routine screening and which are not.  

If you had a lumpectomy (removal of the cancerous lump, along with a margin of healthy tissue) plus radiation therapy, your doctors will probably recommend that you have a mammogram of the treated breast about six months after radiation treatment ends. 

This first mammogram after lumpectomy and radiation will become the new standard against which future mammograms of the remaining breast tissue are compared. After that, you should have mammograms of both the treated breast and the untreated breast at least once a year. 

If you had a mastectomy (removal of the entire breast), screening will depend on whether you had one or both breasts removed and other factors. 

If both breasts and both nipples were removed (a complete double or bilateral mastectomy), then usually no routine screening mammograms are needed. There may not be enough breast tissue left to do a mammogram. However, if your doctors think you’re at high risk of recurrence, they may recommend that you get regular screenings with breast MRI, ultrasound, or a combination of these tests.

If only one breast was removed (a single or unilateral mastectomy), then you should continue to have annual screening mammograms on the unaffected breast.

If you had a nipple-sparing mastectomy (in which all of the breast tissue is removed, but the nipple, areola, and the skin of the breast is left intact), your doctors may recommend that you continue to have annual screening mammograms on the affected breast(s). This is because a small amount of breast tissue might remain under the nipple after a nipple-sparing mastectomy.  

In most cases, you won’t need to continue getting screening mammograms of a breast that has been reconstructed after a mastectomy using an implant, a flap of tissue (autologous reconstruction), or both, unless your doctors think you’re at high risk of recurrence.  

If you had breast reconstruction after lumpectomy, you still need annual cancer screenings with mammograms, other imaging tests, or both.

Generally, it’s best to wait at least six months after having breast reconstruction surgery to start screenings.

Women who have breast implants for cosmetic augmentation (not for breast reconstruction related to breast cancer) should follow the same guidelines on when to start getting mammograms and how often to have them as women who don't have implants. Many experts recommend that women at average risk for breast cancer start getting annual screening mammograms at age 40. Those at higher-than-average risk should ask their doctors about starting mammogram screening at a younger age.

Always tell the staff at the mammogram facility if you have breast implants, both when you make the appointment and when you arrive for your appointment. The technologist should take extra images (called "implant displacement views") to make more of the breast tissue surrounding the implant viewable on the mammogram. 

Learn more about how mammograms are done when you have breast implants.