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Abstract
Purpose
Breast ultrasonography (US) is not recommended for recurrence monitoring after breast cancer surgery due to the lack of evidence for its advantage. The purpose of this study was to evaluate the usefulness of US for detecting local recurrence (LR), regional recurrence (RR) and contralateral breast cancer (CBC) in breast cancer patients during follow-up.
Methods
The medical records of 5,833 breast cancer patients who underwent breast cancer surgery between January 2003 and December 2009 were reviewed retrospectively. Physical examination (PE), mammography (MMG), and US were done routinely to detect recurrences. Detection rate for locoregional and contralateral recurrence was compared between the three modalities.
Results
During the follow-up period, 125 LR, 46 RR, 83 CBC, and 29 synchronous local and regional recurrences developed in 245 patients among the study population of 5,833 breast cancer patients. Median time to recurrence was 34.7 months. The recurrence detection rate was 51.9%, 43.5%, and 90.1% for PE, MMG, and US, respectively. Mean size of the recurrent lesions detected by US (1.57 cm) was smaller than that of PE (2.69 cm) and MMG (2.03 cm) (p=0.002).
Figures and Tables
Table 1
Clinical characteristics of 245 patients who developed local, regional, or contralateral breast tumor recurrences
Table 3
Detection rate of each diagnostic method for ipsilateral breast tumor recurrence after breast conserving surgery
*Ipsilateral breast tumor recurrence developed in 46 patients, however, mammographic densities were unknown in 4 patients. In 3 patients, ultrasonography did not detect the recurrent lesions which was found on physical examination; †Mammographic (MMG) density was determined according to the Breast Imaging Reporting and Data System (BIRADS) classification.
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