Korean J Radiol.  2015 Apr;16(2):219-228. 10.3348/kjr.2015.16.2.219.

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

• Yoon JH
• Kim MJ
• Kim EK
• Moon HJ

• KMID: 2070168
• DOI: http://doi.org/10.3348/kjr.2015.16.2.219

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.

Keyword

Breast cancer; Recurrence; Mammography; Ultrasound; MRI; Surveillance

MeSH Terms

Breast Neoplasms/*radiography/therapy/*ultrasonography
Female
Fluorodeoxyglucose F18/diagnostic use
Humans
Magnetic Resonance Imaging/methods
Mammography/*methods
Neoplasm Metastasis/*diagnosis
Neoplasm Recurrence, Local/*diagnosis
Positron-Emission Tomography/methods
Sensitivity and Specificity
Ultrasonography, Mammary
Fluorodeoxyglucose F18

Figure

• 

  Fig. 1 41-year-old woman who had undergone right partial mastectomy due to invasive ductal carcinoma.Follow-up mammography (A) performed 26 months after surgery revealed mass (arrows) at mastectomy site, which was more prominent compared to follow-up mammography performed 6 months before. Ultrasonography (B) showed 15-mm mass in right upper outer breast correlating to mass detected on mammography. Breast magnetic resonance imaging (C) showed peripherally enhanced mass in right breast (arrows). Subsequent biopsy and surgery were performed and revealed invasive ductal carcinoma.

• 

  Fig. 2 44-year-old woman who had undergone modified radical mastectomy of left breast due to invasive ductal carcinoma.Ultrasonography (US) performed 30 months after surgery (A) revealed 11-mm hypoechoic lesion located within skin layer (arrow). US-guided fine needle aspiration was performed on this lesion, and cytology result was positive for metastatic carcinoma from breast. Breast magnetic resonance imaging (B) showed enhanced nodule in left chest wall (arrow) correlating to proven malignant mass.

• 

  Fig. 3 63-year-old woman who had undergone left mastectomy due to invasive ductal carcinoma.Negative findings were seen on follow-up mammography and ultrasonography performed for surveillance. Follow-up positron emission tomography-computed tomography scan (A, arrows) performed 38 months later for surveillance revealed multiple areas of increased fluorodeoxyglucose uptake in both lungs, mediastinum, and liver. CT scans revealed multiple metastatic nodules in both lower lungs (B, arrows), enlarged metastatic mediastinal lymph nodes (C, arrows), and low-attenuating metastatic mass in caudate lobe of liver (D, arrow).

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