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Evaluation of lesions requesting biopsy according to imaging findings in breast cancer patients who have undergone breast-conserving surgery

Yıl 2024, Cilt: 7 Sayı: 1, 24 - 31, 15.01.2024
https://doi.org/10.32322/jhsm.1332079

Öz

Aims: In patients undergoing breast-conserving surgery (BCS), the traditional follow-up imaging methods of the breast are mammography and ultrasonography. However, after BCS and radiotherapy, it becomes more difficult with imaging methods to detect the presence of recurrence or secondary focus due to the change of normal breast structure in patients. In this study, we aimed to investigate the sensitivity, specificity and malignancy prediction values of imaging methods in the follow-up of patients who underwent BCS.
Methods: 421 patients diagnosed with breast cancer who underwent BCS were retrospectively analyzed. 63 patients with histopathology results, which were categorized as BI-RADS 4 or 5 according to imaging findings in their follow-up after BCS, were included in the study. The age of diagnosis, time taken for biopsy and mammography, ultrasonography and magnetic resonance imaging findings were recorded. Patients were divided into 2 groups (benign and malignant) according to the results of biopsy. According to the pathology results, sensitivity, specificity, positive and negative predictive values and diagnostic accuracy levels of radiological imaging findings were calculated. The significance of the difference between pathology groups in terms of mean age of diagnosis and biopsy time was evaluated by Mann-Whitney U test. Categorical variables were assessed by Yates test or Fisher's exact test.
Results: Of the 63 patients, 49 (77.7%) were benign and 14 (23.3%) were malignant. There was a significant difference between the two groups in mass finding on mammography and posterior acoustic shadowing on US (p=0.011, p=0.049, respectively).
Conclusion: MRI is the most sensitive imaging method in post-BCS follow-up and mammography is the most specificity imaging method. The finding with the highest positive predictive value for malignancy detection is the presence of mass on mammography and posterior acoustic shadow on ultrasonography.

Kaynakça

  • Fisher B, Anderson S, Bryant J, 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(16):1233-1241.
  • Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227-1232
  • Erić I, Petek Erić A, Koprivčić I, Babić M, Pačarić S, Trogrlić B. Independent factors for poor prognosis in young patients with stage I-III breast cancer. Acta Clin Croat. 2020;59(2):242-251.
  • Montagna G, Morrow M. Breast-conserving surgery without radiation therapy for invasive cancer. Clin Breast Cancer. 2021;21(2):112-119. doi: 10.1016/j.clbc.2021.01.001.
  • Veronesi U, Banfi A, Salvadori B, et al. Breast conservation is the treatment of choice in small breast cancer: long-term results of a randomized trial. Eur J Cancer Clin Oncol. 1990;26(6):668-270.
  • Waljee JF, Hu ES, Newman LA, Alderman AK. Predictors of re-excision among women undergoing breast-conserving surgery for cancer. Ann Surg Oncol. 2008;15:1297-1303.
  • Ozmen V, Ozmen T, Dogru V. Breast cancer in Turkiye; an analysis of 20.000 patients with breast cancer. Eur J Breast Heal. 2019;15(3):141-146.
  • Mullenix PS, Cuadrado DG, Steele SR, et al. Secondary operations are frequently required to complete the surgical phase of therapy in the era of breast conservation and sentinel lymph node biopsy. Am J Surg. 2004;187(5):643-646.
  • Nayyar A, Gallagher KK, McGuire KP. Definition and management of positive margins for invasive breast cancer. Surg Clin North Am. 2018;98(4):761-771.
  • Sickles EA, D’Orsi CJ, Bassett LW, Appleton CM, Berg WA, Burnside ES. ACR BI-RADS® Atlas, Breast imaging reporting and data system. Reston, VA: American College of Radiology. 2013;5:39-48.
  • Wilkinson L, Thomas V, Sharma N. Microcalcification on mammography: approaches to interpretation and biopsy. Br J Radiol. 2016;90(1069):20160594.
  • Chansakul T, Lai KC, and Slanetz PJ. The postconservation breast: part 2, imaging findings of tumor recurrence and other long-term sequelae. AJR Am J Roentgenol. 2012;198(2):331-343.
  • Gunhan-Bilgen I, Oktay A. Management of microcalcifications developing at the lumpectomy bed after conservative surgery and radiation therapy. AJR Am J Roentgenol. 2007;188(2):393-398.
  • Liberman L, Van Ze KJ, Dershaw DD, et al. Mammographic features of local recurrence in women who have undergone breast-conserving therapy for ductal carcinoma in situ. AJR. 1997;168(2):489-493.
  • Chetty U, Kirkpatrick AE, Anderson TL, et al. Localization and excision of occult breast lesions. Brit J Surg. 1983;70(10):607-610.
  • Moskowitz M. The predictive value of certain mammographic signs in screening for breast cancer. Cancer. 1983;51(6):1007-1010.
  • Feig SA. Mammographic evaluation of calcifications. RSNA Categorial Course in Breast Imaging. 1995:93-105.
  • Dershaw DD, Giess CS, McCormick B, et al. Patterns of mammographically detected calcifications after breast-conserving therapy associated with tumor recurrence. Cancer. 1997;79(7):1355-1362.
  • Park WJ, Kim EK, Moon HJ. Breast ultrasonography for detection of metachronous ipsilateral breast tumor recurrence. Acta Radiol. 2016;57(10):1171-1177.
  • Constantini M, Belli P, Lombardi R, et al. Characterization of solid breast masses: use of sonographic breast imaging reporting and data system lexicon. J Ultrasound Med. 2006;25(5):649-659.
  • Hong AS, Rosen ER, Soo MS, Baker JA. BI-RADS for sonography: positive and negative predictive values of sonographic features. AJR. 2005;184(4):1260-1265.
  • Bartram A, Gilbert F, Thompson A, Mann GB, Agrawal A. Breast MRI in DCIS size estimation, breast-conserving surgery and oncoplastic breast surgery. Cancer Treat Rev. 2021;94:102158.
  • Sardanelli F, Trimboli RM, Houssami N, et al. Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA). Eur Radiol. 2022;32(3):1611-1623.
  • Belli P, Costantini M, Romani M, Marano P, Pastore G. Magnetic resonance imaging in breast cancer recurrence. Breast Cancer Res Treat. 2002;73:223-235. doi.org/10.1023/A:1015868406986
  • Preda L, Villa G, Rizzo S, et al. Magnetic resonance mammography in the evaluation of recurrence at the prior lumpectomy site after conservative surgery and radiotherapy. Breast Cancer Res. 2006;8(5):R53
  • Giess CS, Poole PS, Chikarmane SA, Sippo DA, Birdwell RL. Screening breast MRI in patients previously treated for breast cancer: diagnostic yield for cancer and abnormal interpretation rate. Acad Radiol. 2015;22(11):1331-1337.
  • Gweon HM, Cho N, Han W, et al. Breast MR imaging screening in women with a history of breast conservation therapy. Radiology. 2014;272(2):366-373.
  • Lehman CD, Lee JM, DeMartini WB, et al. Screening MRI in women with a personal history of breast cancer. J Natl Cancer Inst. 2016;108(3):djv349.
  • Vardanian AJ, Clayton JL, Roostaeian J, et al. Comparison of implant-based immediate breast reconstruction with and without acellular dermal matrix. Plast Reconstr Surg. 2011;128(5):403e-410e.
  • Gorechlad JW, McCabe EB, Higgins JH, et al. Screening for recurrences in patients treated with breast-conserving surgery: is there a role for MRI? Ann Surg Oncol. 2008;15:1703-1709. doi.org/10.1245/s10434-008-9832-2
  • Urano M, Nishikawa H, Goto T, et al. Digital mammographic features of breast cancer recurrences and benign lesions mimicking malignancy following breast-conserving surgery and radiation therapy. Kurume Med J. 2020;65(4):113-121.
Yıl 2024, Cilt: 7 Sayı: 1, 24 - 31, 15.01.2024
https://doi.org/10.32322/jhsm.1332079

Öz

Destekleyen Kurum

yok

Teşekkür

yok

Kaynakça

  • Fisher B, Anderson S, Bryant J, 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(16):1233-1241.
  • Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227-1232
  • Erić I, Petek Erić A, Koprivčić I, Babić M, Pačarić S, Trogrlić B. Independent factors for poor prognosis in young patients with stage I-III breast cancer. Acta Clin Croat. 2020;59(2):242-251.
  • Montagna G, Morrow M. Breast-conserving surgery without radiation therapy for invasive cancer. Clin Breast Cancer. 2021;21(2):112-119. doi: 10.1016/j.clbc.2021.01.001.
  • Veronesi U, Banfi A, Salvadori B, et al. Breast conservation is the treatment of choice in small breast cancer: long-term results of a randomized trial. Eur J Cancer Clin Oncol. 1990;26(6):668-270.
  • Waljee JF, Hu ES, Newman LA, Alderman AK. Predictors of re-excision among women undergoing breast-conserving surgery for cancer. Ann Surg Oncol. 2008;15:1297-1303.
  • Ozmen V, Ozmen T, Dogru V. Breast cancer in Turkiye; an analysis of 20.000 patients with breast cancer. Eur J Breast Heal. 2019;15(3):141-146.
  • Mullenix PS, Cuadrado DG, Steele SR, et al. Secondary operations are frequently required to complete the surgical phase of therapy in the era of breast conservation and sentinel lymph node biopsy. Am J Surg. 2004;187(5):643-646.
  • Nayyar A, Gallagher KK, McGuire KP. Definition and management of positive margins for invasive breast cancer. Surg Clin North Am. 2018;98(4):761-771.
  • Sickles EA, D’Orsi CJ, Bassett LW, Appleton CM, Berg WA, Burnside ES. ACR BI-RADS® Atlas, Breast imaging reporting and data system. Reston, VA: American College of Radiology. 2013;5:39-48.
  • Wilkinson L, Thomas V, Sharma N. Microcalcification on mammography: approaches to interpretation and biopsy. Br J Radiol. 2016;90(1069):20160594.
  • Chansakul T, Lai KC, and Slanetz PJ. The postconservation breast: part 2, imaging findings of tumor recurrence and other long-term sequelae. AJR Am J Roentgenol. 2012;198(2):331-343.
  • Gunhan-Bilgen I, Oktay A. Management of microcalcifications developing at the lumpectomy bed after conservative surgery and radiation therapy. AJR Am J Roentgenol. 2007;188(2):393-398.
  • Liberman L, Van Ze KJ, Dershaw DD, et al. Mammographic features of local recurrence in women who have undergone breast-conserving therapy for ductal carcinoma in situ. AJR. 1997;168(2):489-493.
  • Chetty U, Kirkpatrick AE, Anderson TL, et al. Localization and excision of occult breast lesions. Brit J Surg. 1983;70(10):607-610.
  • Moskowitz M. The predictive value of certain mammographic signs in screening for breast cancer. Cancer. 1983;51(6):1007-1010.
  • Feig SA. Mammographic evaluation of calcifications. RSNA Categorial Course in Breast Imaging. 1995:93-105.
  • Dershaw DD, Giess CS, McCormick B, et al. Patterns of mammographically detected calcifications after breast-conserving therapy associated with tumor recurrence. Cancer. 1997;79(7):1355-1362.
  • Park WJ, Kim EK, Moon HJ. Breast ultrasonography for detection of metachronous ipsilateral breast tumor recurrence. Acta Radiol. 2016;57(10):1171-1177.
  • Constantini M, Belli P, Lombardi R, et al. Characterization of solid breast masses: use of sonographic breast imaging reporting and data system lexicon. J Ultrasound Med. 2006;25(5):649-659.
  • Hong AS, Rosen ER, Soo MS, Baker JA. BI-RADS for sonography: positive and negative predictive values of sonographic features. AJR. 2005;184(4):1260-1265.
  • Bartram A, Gilbert F, Thompson A, Mann GB, Agrawal A. Breast MRI in DCIS size estimation, breast-conserving surgery and oncoplastic breast surgery. Cancer Treat Rev. 2021;94:102158.
  • Sardanelli F, Trimboli RM, Houssami N, et al. Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA). Eur Radiol. 2022;32(3):1611-1623.
  • Belli P, Costantini M, Romani M, Marano P, Pastore G. Magnetic resonance imaging in breast cancer recurrence. Breast Cancer Res Treat. 2002;73:223-235. doi.org/10.1023/A:1015868406986
  • Preda L, Villa G, Rizzo S, et al. Magnetic resonance mammography in the evaluation of recurrence at the prior lumpectomy site after conservative surgery and radiotherapy. Breast Cancer Res. 2006;8(5):R53
  • Giess CS, Poole PS, Chikarmane SA, Sippo DA, Birdwell RL. Screening breast MRI in patients previously treated for breast cancer: diagnostic yield for cancer and abnormal interpretation rate. Acad Radiol. 2015;22(11):1331-1337.
  • Gweon HM, Cho N, Han W, et al. Breast MR imaging screening in women with a history of breast conservation therapy. Radiology. 2014;272(2):366-373.
  • Lehman CD, Lee JM, DeMartini WB, et al. Screening MRI in women with a personal history of breast cancer. J Natl Cancer Inst. 2016;108(3):djv349.
  • Vardanian AJ, Clayton JL, Roostaeian J, et al. Comparison of implant-based immediate breast reconstruction with and without acellular dermal matrix. Plast Reconstr Surg. 2011;128(5):403e-410e.
  • Gorechlad JW, McCabe EB, Higgins JH, et al. Screening for recurrences in patients treated with breast-conserving surgery: is there a role for MRI? Ann Surg Oncol. 2008;15:1703-1709. doi.org/10.1245/s10434-008-9832-2
  • Urano M, Nishikawa H, Goto T, et al. Digital mammographic features of breast cancer recurrences and benign lesions mimicking malignancy following breast-conserving surgery and radiation therapy. Kurume Med J. 2020;65(4):113-121.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Radyoloji ve Organ Görüntüleme, Tanı Radyografisi, Kanser Tanısı
Bölüm Orijinal Makale
Yazarlar

Ebru Torun 0000-0003-0879-5285

Kemal Arda 0000-0002-5404-4303

Zehra Sumru Coşar 0000-0002-8927-0466

Erken Görünüm Tarihi 7 Ocak 2024
Yayımlanma Tarihi 15 Ocak 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 7 Sayı: 1

Kaynak Göster

AMA Torun E, Arda K, Coşar ZS. Evaluation of lesions requesting biopsy according to imaging findings in breast cancer patients who have undergone breast-conserving surgery. J Health Sci Med /JHSM /jhsm. Ocak 2024;7(1):24-31. doi:10.32322/jhsm.1332079

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