J Breast Cancer.  2010 Dec;13(4):403-408. 10.4048/jbc.2010.13.4.403.

Efficacy of Breast Ultrasonography for Detection of Local, Regional, and Contralateral Recurrence of Breast Cancer

Affiliations
  • 1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. hanw@snu.ac.kr
  • 2Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.

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).
CONCLUSION
Breast US had higher recurrence detection rate for LR, RR, and CBC than PE or MMG after breast cancer surgery.

Keyword

Breast neoplasms; Local neoplasm recurrences; Mammography; Ultrasonography

MeSH Terms

Breast
Breast Neoplasms
Follow-Up Studies
Humans
Imidazoles
Mammography
Medical Records
Neoplasm Recurrence, Local
Nitro Compounds
Physical Examination
Recurrence
Retrospective Studies
Ultrasonography, Mammary
Imidazoles
Nitro Compounds

Figure

  • Figure 1 Incidence of 283 recurrence during the follow-up period.


Reference

1. Jung KW, Park S, Kong HJ, Won YJ, Boo YK, Shin HR, et al. Cancer statistics in Korea: incidence, mortality and survival in 2006-2007. J Korean Med Sci. 2010. 25:1113–1121.
Article
2. Cancer Statistics. National Cancer Information Center. accessed Aug 1, 2010. http://www.cancer.go.kr/cms/statics/survival_rate/index.html.
3. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002. 347:1233–1241.
Article
4. Taghian A, Jeong JH, Mamounas E, Anderson S, Bryant J, Deutsch M, et al. Patterns of locoregional failure in patients with operable breast cancer treated by mastectomy and adjuvant chemotherapy with or without tamoxifen and without radiotherapy: results from five National Surgical Adjuvant Breast and Bowel Project randomized clinical trials. J Clin Oncol. 2004. 22:4247–4254.
Article
5. Chen Y, Thompson W, Semenciw R, Mao Y. Epidemiology of contralateral breast cancer. Cancer Epidemiol Biomarkers Prev. 1999. 8:855–861.
6. NCCN Clinical Practice Guidelines in Oncology: Breast Cancer v.2.2010. National Comprehensive Cancer Network. accessed Aug 1, 2010. http://www.nccn.org/professionals/physician_gls/PDF/breast.pdf.
7. Yarnold J. Early and locally advanced breast cancer: diagnosis and treatment National Institute for Health and Clinical Excellence guideline 2009. Clin Oncol (R Coll Radiol). 2009. 21:159–160.
Article
8. Aebi S, Davidson T, Gruber G, Castiglione M. ESMO Guidelines Working Group. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010. 21:Suppl 5. v9–v14.
Article
9. The 3rd Breast Cancer Management Recommendations. Korean Breast Cancer Society. accessed Aug 1, 2010. http://www.kbcs.or.kr/journal/file/3_11.pdf.
10. Lehman CD, Smith RA. The role of MRI in breast cancer screening. J Natl Compr Canc Netw. 2009. 7:1109–1115.
Article
11. Khatcheressian JL, Wolff AC, Smith TJ, Grunfeld E, Muss HB, Vogel VG, et al. American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol. 2006. 24:5091–5097.
Article
12. Kim HJ, Kwak JY, Choi JW, Bae JH, Shin KM, Lee HJ, et al. Impact of US surveillance on detection of clinically occult locoregional recurrence after mastectomy for breast cancer. Ann Surg Oncol. 2010. 17:2670–2676.
Article
13. Moon HJ, Kim MJ, Kim EK, Park BW, Youk JH, Kwak JY, et al. US surveillance of regional lymph node recurrence after breast cancer surgery. Radiology. 2009. 252:673–681.
Article
14. Shin JH, Han BK, Choe YH, Nam SJ, Park W, Im YH. Ultrasonographic detection of occult cancer in patients after surgical therapy for breast cancer. J Ultrasound Med. 2005. 24:643–649.
Article
15. Yilmaz MH, Esen G, Ayarcan Y, Aydoğan F, Ozgüroğlu M, Demir G, et al. The role of US and MR imaging in detecting local chest wall tumor recurrence after mastectomy. Diagn Interv Radiol. 2007. 13:13–18.
16. The ACR Breast Imaging Reporting and Data System (BI-RADS®). American College of Radiology. accessed Oct 25, 2010. http://www.acr.org.
17. Houssami N, Ciatto S, Martinelli F, Bonardi R, Duffy SW. Early detection of second breast cancers improves prognosis in breast cancer survivors. Ann Oncol. 2009. 20:1505–1510.
Article
18. Ciatto S, Miccinesi G, Zappa M. Prognostic impact of the early detection of metachronous contralateral breast cancer. Eur J Cancer. 2004. 40:1496–1501.
Article
19. Montgomery DA, Krupa K, Jack WJ, Kerr GR, Kunkler IH, Thomas J, Dixon JM. Changing pattern of the detection of locoregional relapse in breast cancer: the Edinburgh experience. Br J Cancer. 2007. 96:1802–1807.
Article
20. Houssami N, Ciatto S, Martinelli F, Bonardi R, Duffy SW. Early detection of second breast cancers imporoves prognosis in breast cancer survivors. Ann Oncol. 2009. 20:1505–1510.
Article
21. Gordon PB, Goldenberg SL. Malignant breast masses detected only by ultrasound. A retrospective review. Cancer. 1995. 76:626–630.
Article
22. Giuseppetti GM, Rizzatto G, Gozzi G, Ercolani P. Role of ultrasonics in the diagnosis of subclinical carcinoma of the breast. Radiol Med. 1989. 78:339–342.
23. Kim SH, Kim MH, Oh KK. Analysis and comparison of breast density according to age on mammogram between Korean and Western women. J Korean Radiol Soc. 2000. 42:1009–1014.
Article
24. Kelly KM, Dean J, Lee SJ, Comulada WS. Breast cancer detection: radiologists' performance using mammography with and without automated whole-breast ultrasound. Eur Radiol. 2010. 20:2557–2564.
Article
25. Kim MJ, Kim EK, Kwak JY, Park BW, Kim SI, Sohn J, et al. Sonographic surveillance for the detection of contralateral metachronous breast cancer in an Asian population. AJR Am J Roentgenol. 2009. 192:221–228.
Article
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