Diagnostic and Interventional Radiology
Breast Imaging - Original Article

The role of US and MR imaging in detecting local chest wall tumor recurrence after mastectomy

1.

Department of Radiology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey

2.

From the Departments of Radiology, İstanbul University, Cerrahpaşa School of Medicine, İstanbul, Turkey

3.

Departments of General Surgery, İstanbul University, Cerrahpaşa School of Medicine, İstanbul, Turkey

4.

From the Departments of Medical Oncology, İstanbul University, Cerrahpaşa School of Medicine, İstanbul, Turkey

5.

From the Departments of Radiation Oncology, İstanbul University, Cerrahpaşa School of Medicine, İstanbul, Turkey

Diagn Interv Radiol 2007; 13: 13-18
Read: 600 Downloads: 451 Published: 03 September 2019

Abstract

PURPOSE
To determine the role of clinical examination, ultrasonography (US), and magnetic resonance imaging (MRI) in detecting local tumor recurrence in patients who underwent modified radical mastectomy for breast cancer.

 

MATERIALS AND METHODS
The study included 27 patients who were examined between April 1999 and April 2003. US evaluation of the chest wall was performed in all patients. MRI was performed on 10 patients due to suspicious findings in clinical examination, on 3 patients due to US findings, and on 8 patients due to both US and clinical examination findings. Six patients without any suspicious findings underwent MRI for follow-up purposes. The lesions detected with MRI were evaluated according to their morphology, contrast enhancement characteristics and dynamics. The focal lesions that enhanced intensely at the early phase were accepted as suspicious for malignancy.

 

RESULTS
Of the 10 cases that underwent biopsy secondary to suspicious lesions for malignancy according to MRI findings, 7 were found to have recurrence. In the remaining 3 patients, recurrence diagnosis was made based on the fact that the lesions regressed in response to chemotherapy. In 17 cases, there were no suspicious findings on MRI for local recurrence. In 2 of these cases, biopsies were performed due to suspicious US findings; however, no malignancies were detected. The sensitivity and specificity of clinical examination in detecting local recurrence was 70% and 35.2%, respectively. These values were 90% and 88.2% for US, and 100% and 100% for MRI.

 

CONCLUSION
In patients with mastectomy, US and MRI were more successful in detecting local recurrence than clinical examination. Considering the fact that US is cheaper and more readily available than MRI, it should be part of the routine follow-up in order to detect local recurrence early. MRI will be helpful in cases with suspicious US findings by increasing the specificity of the evaluation as well as determining the actual size and spread of any lesions, which is valuable information for the subsequent management and response to the particular treatment.

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