Surveillance for second breast cancer events in women with a personal history of breast cancer using breast MRI: a systematic review and meta-analysis

Haas, Cameron B; Nekhlyudov, Larissa; Lee, Janie M.; Javid, Sara H.; Bush, Mary; Johnson, Dianne; Gleason, Timothy R.; Kaufman, Cary S.; Specht, Jennifer M.; Stitham, Sean; Wernli, Karen J.

doi:10.1007/s10549-020-05637-y

Cited by 17 publications

(6 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent meta-analysis investigating the performance of breast MRI as a surveillance method for patients with a personal history of breast cancer concluded that the evidence is insufficient to recommend for or against the use of MRI in this setting. 35 That meta-analysis included mostly patients treated with BCS and analyzed the detection rates using the sum of ipsilateral and contralateral cancers, resulting in a higher pooled cancer detection rate compared with our results of 5.17 per 1000 examinations by using breast MRI.…”

Section: Discussionsupporting

confidence: 85%

Yield of Surveillance Imaging After Mastectomy With or Without Reconstruction for Patients With Prior Breast Cancer

et al. 2022

View full text Add to dashboard Cite

ImportanceA discrepancy on current guidelines and clinical practice exists regarding routine imaging surveillance after mastectomy, mainly regarding the lack of adequate evidence for imaging in this setting.ObjectiveTo investigate the usefulness of imaging surveillance in terms of cancer detection and interval cancer rates after mastectomy with or without reconstruction for patients with prior breast cancer.Data SourcesA comprehensive literature search was conducted in 3 electronic databases—PubMed, ISI Web of Science, and Scopus—without year restriction. References from relevant reviews and eligible studies were also manually searched.Study SelectionEligible studies were defined as those conducting surveillance imaging (mammography, ultrasonography, or magnetic resonance imaging [MRI]) of patients with prior breast cancer after mastectomy with or without reconstruction that presented adequate data to calculate cancer detection rates for each surveillance method.Data Extraction and SynthesisIndependent data extraction by 2 investigators with consensus on discrepant results was performed. A quality assessment of studies was performed using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies–2) template. The generalized linear mixed model framework with both fixed-effects and random-effects models was used to meta-analyze the proportion of cases across studies including 3 variables: surveillance method, reconstruction after mastectomy, and surveillance measure.Main Outcomes and MeasuresThree outcome measures were calculated for each eligible study and each surveillance imaging method within studies: overall cancer detection (defined as ipsilateral cancer, both palpable and nonpalpable) rate per 1000 examinations, clinically occult (nonpalpable) cancer detection rate per 1000 examinations, and interval cancer rate per 1000 examinations.ResultsIn total, 16 studies were eligible for the meta-analysis. The pooled overall cancer detection rates per 1000 examinations were 1.86 (95% CI, 1.05-3.30) for mammography, 2.66 (95% CI, 1.48-4.76) for ultrasonography, and 5.17 (95% CI, 1.49-17.75) for MRI. For mastectomy without reconstruction, the rate of clinically occult (nonpalpable) cancer per 1000 examinations (2.96; 95% CI, 1.38-6.32) and the interval cancer rate per 1000 examinations (3.73; 95% CI, 0.84-3.98) were lower than the overall cancer detection rate (including both palpable and nonpalpable lesions) per 1000 examinations (6.41; 95% CI, 3.09-13.25) across all imaging modalities. The interval cancer rate per 1000 examinations for mastectomy with reconstruction (3.73; 95% CI, 0.41-2.73) was comparable to the pooled cancer detection rate per 1000 examinations (4.73; 95% CI, 2.32-9.63) across all imaging modalities. In all clinical scenarios and imaging modalities, lower rates of clinically occult cancer compared with cancer detection rates were observed.Conclusions and RelevanceLower detection rates of clinically occult—compared with overall—cancer across all 3 imaging modalities challenge the use of imaging surveillance after mastectomy, with or without reconstruction. Findings suggest that imaging surveillance in this context is unnecessary in clinical practice, at least until further studies demonstrate otherwise. Future studies should consider using the clinically occult cancer detection rate as a more clinically relevant measure in this setting.

show abstract

Section: Discussionsupporting

confidence: 85%

Yield of Surveillance Imaging After Mastectomy With or Without Reconstruction for Patients With Prior Breast Cancer

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Breast cancer generally has a favorable prognosis in developed countries, partly due to detection at early and asymptomatic stages, thanks to the establishment of screening practices and therapeutic advances [14,15]. Tools like the widely recognized Breast Cancer Risk Assessment Tool (BCRAT or Gail model) that were developed and adapted for the disparity in racial and ethnic groups in developed countries, in particular in the United States, have been proving to be challenging to adapt to developing countries [16,17], including Cameroon, where information about the epidemiology and diversity of dominant risk factors of breast cancer in female populations is often scarce [8,18].…”

Section: Introductionmentioning

confidence: 99%

Awareness of Breast Cancer Screening among the Medical and General Population of the North Region of Cameroon

Tagne

Baiguerel

Kamdje

et al. 2021

International Journal of Breast Cancer

View full text Add to dashboard Cite

Breast cancer has become a real public health problem in Cameroon, particularly in rural areas due to late diagnosis, resulting partly from the absence of national screening programs. This work is aimed at assessing breast cancer awareness in the North Region of Cameroon. Participants were selected in six health centers surrounding the rural area of Garoua, North Region, Cameroon, and administered a questionnaire aimed at assessing their awareness about breast cancer risk factors and screening. Out of the 475 women (including 37 medical personnel) interviewed, 45.5% attended at least secondary school; 91.3% were aware of the disease with the main sources of information from those around them (64.8%), media (46.5%), and health professionals in health facilities (42.7%). 23.3% had misconceptions and myth-based ideas on the origin of the disease. Ignorance was the main reason preventing the performance of breast self-examination, and the high cost prevents individuals from going for mammography. The highest awareness rate was observed in employed women with higher level of education. Our study highlights the need to raise awareness among the populations in North Region, Cameroon, about the risk factors and clinical signs of breast cancer and the importance of screening practice for early diagnosis of breast cancer.

show abstract

“…Early detection of breast cancer in asymptomatic women through screening is aimed at detecting the disease when it is less invasive, reducing advanced stage-associated morbidity and its rate of mortality [14] [15]. Tools like the widely recognized Breast Cancer Risk Assessment Tool (BCRAT or Gail model) that were developed and adapted for the disparity in racial and ethnic groups in developed countries, in particular in the United States, has been proving challenging to adapt to developing countries [16] [17], including in Cameroon, where information about the epidemiology and diversity of dominant risk factors of breast cancer in female populations is often scarce [8] [18].…”

Section: Introductionmentioning

confidence: 99%

Breast Cancer and Its Screening Awareness in the North Region of Cameroon

Baiguerel¹,

Tagne²,

Nwabo³

et al. 2021

JCT

View full text Add to dashboard Cite

Due to the late diagnosis, resulting partly from the absence of national screening programs, breast cancer has become a real public health problem in Cameroon, particularly in rural areas. This work aimed to assess breast cancer awareness in the North Region of Cameroon. Participants were selected randomly in six health centers surrounding rural areas of Garoua, North Region of Cameroon, and administered a questionnaire aimed at assessing their awareness about breast cancer warning signs and screening methods. Out of 475 women (including 37 medical personnel) interviewed, 23.3% had misconceptions and myth-based ideas on the origin of the disease. Employed women were more aware of breast cancer, its risk factors and symptoms as compared to other groups (p < 0.0001) for most of the risk factors and symptoms. Participants with higher education and employed women were also more aware of breast cancer screening, including breast self-examination mammography, and breast ultrasound (p < 0.0001 vs. other groups). Breast cancer screening and breast self-examination were mostly performed by women with higher education and employed women (p < 0.0001 compared to other groups). Ignorance was the main reason preventing women from performing breast self-examination and the high cost prevented going for mammography. Our study highlights the need to raise awareness among the populations in Cameroon North Region about the risk factors and clinical signs of breast cancer and the importance of screening practice for the early diagnosis of breast cancer.

show abstract

Surveillance for second breast cancer events in women with a personal history of breast cancer using breast MRI: a systematic review and meta-analysis

Cited by 17 publications

References 57 publications

Yield of Surveillance Imaging After Mastectomy With or Without Reconstruction for Patients With Prior Breast Cancer

Yield of Surveillance Imaging After Mastectomy With or Without Reconstruction for Patients With Prior Breast Cancer

Awareness of Breast Cancer Screening among the Medical and General Population of the North Region of Cameroon

Breast Cancer and Its Screening Awareness in the North Region of Cameroon

Contact Info

Product

Resources

About