Local staging of ipsilateral breast tumor recurrence: mammography, ultrasound, or MRI?

Coco J. E. F. Walstra*, Robert-Jan Schipper, Gonneke A. Winter-Warnars, Claudette E. Loo, Adri C. Voogd, Marie-Jeanne T. F. D. Vrancken Peeters, Grard A. P. Nieuwenhuijzen, Regina G. H. Beets-Tan

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

Background Despite increasingly effective curative breast-conserving treatment (BCT) regimens for primary breast cancer, patients remain at risk for an ipsilateral breast tumor recurrence (IBTR). With increasing interest for repeat BCT in selected patients with IBTR, a reliable assessment of the size of IBTR is important for surgical planning. Aim The primary aim of this study is to establish the performance in size estimation of XMG, US, and breast MRI in patients with IBTR. The secondary aim is to compare the detection of multifocality and contralateral lesions between XMG and MRI. Patients and methods The sizes of IBTR on mammography (XMG), ultrasound (US), and magnetic resonance imaging (MRI) in 159 patients were compared to the sizes at final histopathology. The accuracy of the size estimates was addressed using Pearson's coefficient and Bland-Altman plots. Secondary outcomes were the detection of multifocality and contralateral lesions between XMG and MRI. Results Both XMG and US significantly underestimated the tumor size by 3.5 and 4.8 mm, respectively, while MRI provided accurate tumor size estimation with a mean underestimation of 1.1 mm. The sensitivity for the detection of multifocality was significantly higher for MRI compared to XMG (25.5% vs. 5.5%). A contralateral malignancy was found in 4.4% of patients, and in 1.9%, it was detected by MRI only. Conclusion The addition of breast MRI to XMG and US in the preoperative workup of IBTR allows for more accurate size estimation. MRI provides a higher sensitivity for the detection of multifocality compared to XMG.

Original languageEnglish
Pages (from-to)385-395
Number of pages11
JournalBreast Cancer Research and Treatment
Volume184
Issue number2
Early online date8 Aug 2020
DOIs
Publication statusPublished - Nov 2020

Keywords

  • Ipsilateral breast cancer recurrence
  • Tumor size estimation
  • Mammography
  • Breast ultrasound
  • Breast MRI
  • TERM-FOLLOW-UP
  • CONTRALATERAL BREAST
  • CONSERVING THERAPY
  • PRESERVING SURGERY
  • REIRRADIATION PBRI
  • MUTATION CARRIERS
  • PHASE-II
  • CANCER
  • SIZE
  • IMPACT

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