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US screening for detection of nonpalpable locoregional recurrence after mastectomy

 Jin Hwa Lee  ;  Eun-Kyung Kim  ;  Jong Young Oh  ;  Hyuk-Chan Kwon  ;  Seong Hwan Kim  ;  Dae Cheol Kim  ;  Miri Lee  ;  Se Heon Cho  ;  Kyung Jin Nam 
 EUROPEAN JOURNAL OF RADIOLOGY, Vol.82(3) : 485-489, 2013 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/epidemiology ; Breast Neoplasms/surgery* ; Female ; Humans ; Mass Screening/statistics & numerical data* ; Mastectomy* ; Middle Aged ; Neoplasm Recurrence, Local/diagnostic imaging* ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/prevention & control* ; Palpation/statistics & numerical data ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Factors ; Sensitivity and Specificity ; Treatment Outcome ; Ultrasonography, Mammary/statistics & numerical data*
Breast neoplasms ; Surgery ; Screening ; Ultrasonography
PURPOSE: To assess the value of screening ultrasonography (US) in the detection of nonpalpable locoregional recurrence following mastectomy for breast cancer and to describe the US appearances of occult recurrent cancers. MATERIALS AND METHODS: During a 36-month period, 1180 consecutive US screenings were performed for mastectomy sites and ipsilateral axillary fossae in 468 asymptomatic women who had undergone mastectomy for breast cancer. All US results were divided into three groups: negative findings, probably benign nodules, and suspicious for malignant nodules. The final diagnoses were based on pathology results and clinical or sonographic follow-up for more than 12 months. The diagnostic performance of US for detecting nonpalpable locoregional recurrence was assessed. The US appearances of occult recurrent cancers were retrospectively reviewed. RESULTS: Of the 468 patients assessed, 19 (4.1%) showed "suspicious for malignant nodules"; of these lesions, 10 were malignant. One false-negative case was identified. The sensitivity and specificity were 90.9% and 98.0%, respectively. A biopsy positive predictive value of 52.6% was observed. Cancer detection rates were 2.1% with US screenings of mastectomy sites and ipsilateral axillary fossae. The common US features of occult recurrences at the mastectomy sites were irregular shaped, not-circumscribed marginated, and hypoechoic masses with intratumoral vascularities. The most common location was within the deep muscle layer. CONCLUSION: Although locoregional recurrence infrequently occurs after mastectomy for breast cancer, screening US enables detection of nonpalpable cancer before it can be detected by clinical examination. Routine follow-up US can be advocated for early detection of nonpalpable locoregional recurrent cancer.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
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