Accuracy of Ultrasonographic Surveillance in Detecting First Locoregional Recurrence of Breast Cancer Postsurgery
Ultrasonographic Surveillance in Detecting Breast Cancer Recurrence
Keywords:
locoregional recurrence, ultrasound, surveillance, breast cancer, asymptomatic periodAbstract
Breast cancer recurrence is one of the factors predicting cancer spread. This study aimed to assess performance of ultrasonographic surveillance for detecting clinically occult first locoregional recurrence after breast cancer surgery and to determine sonographic characteristics indicating recurrent cancers. During a four years period; screening of 1,437 asymptomatic non-recurrent patients who underwent surgical treatment for breast cancer were retrospectively reviewed according to ACR BI-RADS. All BI-RADS 4/5 patients were assessed sonographic appearances at surgical beds and regional nodes. Final diagnoses were made on the basis of pathology or advanced imaging. Of these, 36 (2.5%) had suspicious recurrence by the ultrasound including 20 lesions at the surgical bed and 18 lesions at the regional nodes. Twenty-two (1.5%) were made the diagnoses of locoregional recurrence, 15 of whom occurred at the regional nodes. One had false-negative result at chest wall. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the ultrasound for detecting occult locoregional recurrence was 99.0% (1,422/1,437), 95.7% (22/23), 99.0% (1,400/1,414), 61.1% (22/36), and 99.9% (1,400/1,401), respectively. Sonographic characteristics at the surgical beds was irregular shape (p = 0.008) and non-circumscribed margin (p = 0.005), and the characteristics at the regional nodes was moderate to marked hypoechogenicity (p < 0.001). In conclusion, ultrasonographic surveillance is accurate and beneficial for early detection of locoregional recurrence in asymptomatic patients after breast cancer surgery
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