Imaging Surveillance of Patients with Breast Cancer after Primary Treatment: Current Recommendations

Abstract

Women who have been treated for breast cancer are at risk for second breast cancers, such as ipsilateral recurrence or contralateral metachronous breast cancer. As the number of breast cancer survivors increases, interest in patient management and surveillance after treatment has also increased. However, post-treatment surveillance programs for patients with breast cancer have not been firmly established. In this review, we focus on the imaging modalities that have been used in post-treatment surveillance for patients with breast cancer, such as mammography, ultrasonography, magnetic resonance imaging, and positron emission tomography, the effectiveness of each modality for detecting recurrence, and how they can be applied to manage patients.

Imaging Surveillance for Survivors of Breast Cancer: Correlation between Cancer Characteristics and Method of Detection

“…MRI also demonstrated comparable sensitivity (75%–100%) and specificity (66.6%–93%) with acceptable accuracy (95%) [10]. These studies suggest a potential role of supplemental imaging tests in survivors of breast cancer.…”

Estimation of T2* Relaxation Time of Breast Cancer: Correlation with Clinical, Imaging and Pathological Features

“…Dynamic contrast-enhanced (DCE) MRI is an integral part of the proposed standard protocol Imagingfor breast cancer diagnosis, which provides important information about temporal and spatial uptake of the contrast medium (56). Recently, research focused on diffusion-weighted imaging, proton spectroscopy, and perfusion MRI, has suggested that these techniques may offer potential improvements for diagnostic breast imaging (789101112). …”

Power Doppler Ultrasonography and Shear Wave Elastography as Complementary Imaging Methods for Suspected Local Breast Cancer Recurrence

“…There is evidence that early detection of recurrence in asymptomatic patients during posttreatment follow‐up has potential benefits . However, posttreatment surveillance programs for patients with breast cancer have not yet been firmly established . A regular history, physical examination, and mammography are usually recommended for breast cancer follow‐up …”

“…Ultrasonography (US) is a useful surveillance imaging method for the breast, axillary areas, and chest wall in women who have received breast cancer treatment . Ultrasonography can show ipsilateral recurrent or contralateral metachronous breast cancers with higher sensitivity (91%–97%) than palpation or mammography, which have achieved sensitivity values of 45.5% to 79.0% and 45.0% to 87.0%, respectively . However, a higher cancer detection yield is associated with an increased rate of false‐positive findings…”

“…Magnetic resonance imaging has high sensitivity and specificity for differentiating posttreatment breast changes from recurrent malignancies, particularly when performed more than 12 months after treatment with either breast‐conserving surgery and radiotherapy or mastectomy . However, the diagnostic capabilities of magnetic resonance imaging do not seem to justify the elevated costs associated with its routine use for the detection of breast cancer recurrence …”