Sure. I'm not a surgeon, but I do see a lot of patients with early-stage breast cancer.
The current guidelines for surveillance after a breast cancer diagnosis is annual breast imaging of both breasts. Having a singular breast cancer diagnosis does increase your risk of having contralateral breast cancer, so for our breast cancer survivors, our recommendation is to have annual mammography screening for, essentially, the rest of their lives.
Typically, patients who have undergone treatment would have their first mammography screening.... At least here in Ottawa, our standard would be to do it six months after the completion of radiotherapy, as their baseline.
I agree with Dr. Appavoo that it's very difficult to comment on an individual case, and I think some of our guidelines have evolved over the years. Now we're doing a lot more MRIs for patients at time of diagnosis, especially if they have risk factors like dense breasts, to ensure that there are no small contralateral lesions that are being missed.
However, it is currently not the standard of care to automatically do a prophylactic contralateral mastectomy because it has not been demonstrated to improve survival. The focus, rather, is annual screening in all breast cancer survivors, which is also a problem in our breast screening programs because in most provinces breast cancer survivors are excluded from screening, meaning they have to go back to their primary care providers year after year to get those screening mammograms.