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Value of Ultrasound for Postoperative Surveillance of Asian Patients with History of Breast Cancer Surgery: A Single-Center Study

 Young Joo Suh  ;  Min Jung Kim  ;  Eun-Kyung Kim  ;  Hee Jung Moon  ;  Seung-Il Kim  ;  Byeong-Woo Park 
 ANNALS OF SURGICAL ONCOLOGY, Vol.20(11) : 3461-3468, 2013 
Journal Title
Issue Date
Adult ; Aged ; Breast Neoplasms/classification ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Segmental* ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local/diagnostic imaging* ; Neoplasm Recurrence, Local/prevention & control ; Neoplasm Staging ; Postoperative Complications/diagnostic imaging* ; Prognosis ; Retrospective Studies ; Ultrasonography, Mammary/methods* ; Young Adult
Positive Predictive Value ; Contralateral Breast ; Breast Conservation Surgery ; Ipsilateral Breast Tumor Recurrence ; Postoperative Surveillance
Purpose To assess the diagnostic performance of postoperative ultrasound (US) surveillance for the detection of malignant lesions and to evaluate the clinical role of US in the postoperative surveillance of patients with breast cancer history. Methods We studied a total of 390 patients who underwent surgery for breast cancer between January 2000 and December 2002, 286 mastectomy patients, 103 breast conservation surgery (BCS) patients, and one with both mastectomy and BCS. A total of 4,081 US examinations by December 2010 were reviewed. The final diagnosis for final-positive lesions was based on cytopathology results, clinical follow-up, and imaging studies. Diagnostic performances for detecting final-positive lesions were assessed. We also compared the frequency of distant metastases in patients with final-positive findings and those without. The overall survival was estimated. Results Among 2,925 examinations in 287 patients with mastectomy, there were 85 US-positive and 23 final-positive lesions (27 %) in 20 patients at final diagnosis. Among 1,171 examinations in 104 BCS patients, there were 32 US-positive and five final-positive (15.6 %) findings in four patients. The sensitivity, specificity, positive predictive value, and accuracy of US for final-positive lesions after breast cancer surgery were 95.8,97.8, 27.1, and 97.9 % in mastectomy patients and 42.9, 97.5, 9.4, and 97.2 % in BCS patients. Among mastectomy patients, patients with final-positive findings had a higher incidence of distant metastasis than patients without final-positive findings (31.6 vs. 9.3 %, p = 0.01). Among BCS patients, there was no distant metastasis. Among mastectomy patients, the overall survival was not significantly different between patients with only final-positive findings and in patients with final-positive findings and distant metastasis (p > 0.05). Conclusions Postoperative US had a high sensitivity for the detection of malignant lesions in the breast and the regional area, which can be a predictor of distant metastasis in mastectomy patients; however, the role of postoperative US in the detection of malignant lesions in BCS patients is unclear.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Seung Il(김승일)
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Park, Byeong Woo(박병우) ORCID logo https://orcid.org/0000-0003-1353-2607
Suh, Young Joo(서영주) ORCID logo https://orcid.org/0000-0002-2078-5832
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