Recurrent Disease after Breast Preserving Therapy (BPT) and Radiation Therapy for Breast Cancer - Diagnostic Yield of Palpation, Mammography and Ultrasonography

Abstract

For diagnosing recurrent disease in patients status post BPT and radiation therapy, ultrasonography is superior to palpation and/or mammography and should become an obligatory follow-up tool. The role of mammographic follow-up appears overrated and the role of ultrasonographic assessment underrated. The S-3 guidelines will need to be changed accordingly.

The detection of recurrent breast cancer in patients with a history of breast cancer surgery: comparison of clinical breast examination, mammography and ultrasonography

“…In the present study, the detection ability of US for recurrent tumors following breast cancer surgery was found to be markedly superior to those of clinical breast examination and mammography, which concurs with the findings of other studies (10). Recently, some reports have also supported the use of US surveillance for the detection of regional lymph node recurrence and contralateral metachronous breast cancer after breast cancer surgery (6,8,9).…”

FDG-PET and other imaging modalities for the evaluation of breast cancer recurrence and metastases: a meta-analysis

“…The reasons for exclusion were as follows: (a) the aim of the articles was not to reveal the diagnostic value of US, CT, MRI, SMM, FDG-PET (with or without CT) for identification and characterization of recurrent or metastatic breast cancer ( n  = 817); (b) the reference standard was not used as histopathologic analysis or close clinical and imaging follow-up for at least 6 months ( n  = 79); (c) data from the article that could be used to construct or calculate TP, FP, TN and FN ( n  = 39); (d) data from the article come from a combination of different imaging modalities that could not be differentiated for assessment of single tests ( n  = 32); (e) article was printed more than once, article with smaller population was excluded ( n  = 2); (f) article that cannot be accessible ( n  = 3); (g) data included less than 10 patients ( n  = 3). A total of 43 studies (Yilmaz et al 2007; Bongers et al 2004; Schmidt et al 2008; Radan et al 2006; Ternier et al 2006; Rissanen et al 1993; Bruneton et al 1986; Lee et al 1993; Gilles et al 1993; Dehdashti et al 1995; Melani et al 1995; Hagay et al 1996; Winehouse et al 1999; Rieber et al 1997; Drew et al 1998; Muüller et al 1998; Moon et al 1998; Cwikla et al 1998; Hathaway et al 1999; Qayyum et al 2000; Stuhrmann et al 2000; Bäz et al 2000; Eubank et al 2001, 2004; Kim et al 2001; Belli et al 2002; Liu et al 2002; Goerres et al 2003; Suárez et al 2002; Kamel et al 2003; Gallowitsch et al 2003; Siggelkow et al 2003; De Cicco et al 2004; Shin et al 2005; Weir et al 2005; Lamuraglia et al 2005; Preda et al 2006; Wolfort et al 2006; Piperkova et al 2007; Rajkovaca et al 2007; Usmani et al 2007; Haug et al 2007; Riebe et al 2007) fulfilled all of the inclusion criteria and were considered for the analysis (Table 1). 15 studies were prospective, 16 studies were retrospective, and the remaining was not defined.…”

“…However, reports in the literature differ with regard to diagnostic accuracy of CT imaging in detecting recurrent and/or metastatic breast cancer, ranging from 40 to 92% and from 41 to 100% for SE and SP, respectively (Radan et al 2006; Ternier et al 2006; Winehouse et al 1999; Bäz et al 2000; Gallowitsch et al 2003; Piperkova et al 2007; Riebe et al 2007; Armington et al 1987). Recently, CT has been the main modality used to evaluate mediastinal nodes in oncology, but as this technique uses size as the main criterion to assess nodal status, it is limited by poor SE.…”

The emergence of diagnostic imaging technologies in breast cancer: discovery, regulatory approval, reimbursement, and adoption in clinical guidelines

“…Ultrasonography is also the primary method of imaging palpable breast masses in women under 30 years old, since the density of the breast tissue in younger women rules out mammography [ 58 ] . Ultrasonography is recommended for surveillance in women who have had mastectomies [ 60–62 ] and breast conservation therapy [ 63 , 64 ] .…”