Breast conservation therapy in patients with mammographically undetected breast cancer.

Abstract

The authors reviewed their experience with 542 patients with breast cancer who were treated with conservative surgery and radiation therapy (CSRT) and analyzed the outcome in those patients whose tumors could not be detected with mammography. Fifty-five of the patients (10.1%) had a palpable, pathologically confirmed breast carcinoma and a negative preoperative mammogram. Routine follow-up included annual mammography and physical examination. The local recurrence, 5-year actuarial survival, and 5-year disease-free survival rates for these 55 patients did not differ significantly from those for patients with positive mammograms. There were six cases of local breast recurrence in this subgroup. Four of five cases were visible on mammograms (one patient did not undergo mammography at the time of recurrence); two of the cases were detected with mammography alone following physical examination with negative results. The authors conclude that patients with palpable but mammographically occult early-stage breast cancer are suitable candidates for CSRT and that mammography is a mandatory part of follow-up of conservatively treated patients.

Prognosis for Mammographically Occult, Early-Stage Breast Cancer Patients Treated With Breast-Conservation Therapy

“…For patients presenting with mammographically occult primary tumors (MamOcc) who choose BCT, the data on outcomes after conservative surgery and radiotherapy are limited. Although some studies suggest that patients with palpable but mammographically occult early-stage breast cancer are still candidates for BCT (5)(6)(7), others have reported that false-negative mammograms are primarily indicative of diffuse or extensive disease, suggesting that patients presenting with MamOcc are poor candidates for BCT (8). In addition, questions regarding long-term follow-up and future breast recurrences being undetectable by mammography have evoked concern in patients and physicians alike.…”

Differentiation between benign and malignant findings on MR-mammography: usefulness of morphological criteria

“…The main diagnostic tools in breast cancer detection are physical examination, mammography, ultrasound and cytology. Although mammography detects carcinomas at an earlier stage than physical examination, 5±15 % of palpable breast lesions are mammographically occult [2,3,4].…”

“…The main diagnostic tools in breast cancer detection are physical examination, mammography, ultrasound and cytology. Although mammography detects carcinomas at an earlier stage than physical examination, 5±15 % of palpable breast lesions are mammographically occult [2,3,4].Breast MRI is regarded as a potential tool in breast cancer diagnosis and has gained more clinical importance in the recent years. The main advantage of breast MRI is its high sensitivity of 88±100 % [5, 6, 7], compared with mammography, which has sensitivity of between 69 % and 75 % [8,9].…”