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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2013

01-10-2013 | Breast Oncology

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

Authors: Young Joo Suh, MD, Min Jung Kim, MD, Eun-Kyung Kim, MD, Hee Jung Moon, MD, Seung-Il Kim, MD, Byeong-Woo Park, MD

Published in: Annals of Surgical Oncology | Issue 11/2013

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Abstract

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.
Literature
1.
Taghian A, Jeong JH, Mamounas E, 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;22:4247–54.PubMedCrossRef
2.
Anderson SJ, Wapnir I, Dignam JJ, et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer. J Clin Oncol. 2009;27:2466–73.PubMedCrossRef
3.
Kim HJ, Kwak JY, Choi JW, et al. Impact of US surveillance on detection of clinically occult locoregional recurrence after mastectomy for breast cancer. Ann Surg Oncol. 2010;17:2670–6.PubMedCrossRef
4.
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;24:643–9.PubMed
5.
Lu W, Schaapveld M, Jansen L, et al. The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer. Eur J Cancer. 2009;45:3000–7.PubMedCrossRef
6.
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;20:1505–10.PubMedCrossRef
7.
Khatcheressian JL, Wolff AC, Smith TJ, 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;24:5091–7.PubMedCrossRef
8.
Moon HJ, Kim MJ, Kim EK, et al. US surveillance of regional lymph node recurrence after breast cancer surgery. Radiology. 2009;252:673–81.PubMedCrossRef
9.
Kim MJ, Kim EK, Kwak JY, et al. Role of sonography in the detection of contralateral metachronous breast cancer in an Asian population. AJR Am J Roentgenol. 2008;190:476–80.PubMedCrossRef
10.
Shin H, Won Y, Jung K, et al. Nationwide cancer incidence in Korea, 1999~2001; first result using the National Cancer Incidence Database. Cancer Res Treat. 2005;37:325–31.PubMedCrossRef
11.
Rissanen TJ, Makarainen HP, Mattila SI, Lindholm EL, Heikkinen MI, Kiviniemi HO. Breast cancer recurrence after mastectomy: diagnosis with mammography and US. Radiology. 1993;188:463–7.PubMed
12.
Kim SM, Park JM. Normal and abnormal US findings at the mastectomy site. Radiographics. 2004;24:357–65.PubMedCrossRef
13.
Gordon PB, Goldenberg SL. Malignant breast masses detected only by ultrasound. A retrospective review. Cancer. 1995;76:626–30.
14.
Buchberger W, Niehoff A, Obrist P, DeKoekkoek-Doll P, Dunser M. Clinically and mammographically occult breast lesions: detection and classification with high-resolution sonography. Semin Ultrasound CT MR. 2000;21:325–36.PubMedCrossRef
15.
Kaplan SS. Clinical utility of bilateral whole-breast US in the evaluation of women with dense breast tissue. Radiology. 2001;221:641–9.PubMedCrossRef
16.
Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology. 2002;225:165–75.PubMedCrossRef
17.
Crystal P, Strano SD, Shcharynski S, Koretz MJ. Using sonography to screen women with mammographically dense breasts. AJR Am J Roentgenol. 2003;181:177–82.PubMedCrossRef
18.
Leconte I, Feger C, Galant C, et al. Mammography and subsequent whole-breast sonography of nonpalpable breast cancers: the importance of radiologic breast density. AJR Am J Roentgenol. 2003;180:1675–9.PubMedCrossRef
19.
Robertson C, Ragupathy SK, Boachie C, et al. Surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer: a systematic review. Eur Radiol. 2011;21:2484–91.PubMedCrossRef
20.
Lu WL, Jansen L, Post WJ, Bonnema J, Van de Velde JC, De Bock GH. Impact on survival of early detection of isolated breast recurrences after the primary treatment for breast cancer: a meta-analysis. Breast Cancer Res Treat. 2009;114:403–12.PubMedCrossRef
21.
Chen SC, Chang HK, Lin YC, et al. Prognosis of breast cancer after supraclavicular lymph node metastasis: not a distant metastasis. Ann Surg Oncol. 2006;13:1457–65.PubMedCrossRef
Metadata
Title
Value of Ultrasound for Postoperative Surveillance of Asian Patients with History of Breast Cancer Surgery: A Single-Center Study
Authors
Young Joo Suh, MD
Min Jung Kim, MD
Eun-Kyung Kim, MD
Hee Jung Moon, MD
Seung-Il Kim, MD
Byeong-Woo Park, MD
Publication date
01-10-2013
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 11/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3020-8

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