J Breast Cancer.  2017 Jun;20(2):192-197. 10.4048/jbc.2017.20.2.192.

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

• Chu AJ
• Chang JM
• Cho N
• Moon WK

• KMID: 2389757
• DOI: http://doi.org/10.4048/jbc.2017.20.2.192

Abstract

PURPOSE
The aim of our study was to investigate the characteristics of primary and recurrent breast cancers and the correlation between cancer subtypes and detection modes.
METHODS
Between 2003 and 2013, 147 cases of recurrent breast cancer in 137 women (mean age, 45.30±10.78 years) were identified via an annual clinical examination using radiological studies among 6,169 patients with a breast cancer history (mean follow-up period, 13.26±1.78 years). Clinical, radiological, and pathological findings including immunohistochemistry findings of primary and recurrent cancers were reviewed. The size of the tumor in primary and recurrent cancers, disease-free survival, methods of surgery, and the recurrence detection modalities were analyzed with respect to the breast cancer subtype.
RESULTS
Ipsilateral and contralateral in-breast recurrence occurred in 105, 21 had axillary lymph node recurrence, and 21 had chest wall recurrences. The subtypes of the primary cancers were hormone receptor (HR) positive and human epidermal growth factor receptor 2 (HER2) negative (HR+HER2−) in 57, HER2 positive (HER2+) in 39, and triple-negative type in 51, and the recurrent cancers in each subtype showed the same type as the primary cancer in 84.3% of cases. In the in-breast recurrent cancers, the HR+HER2− cancers were most frequently detected using ultrasonography (15/43) followed by mammography (MG) (11/43). The HER2+ recurrent cancers were most commonly detected using MG (14/31, 45.2%), whereas triple-negative type recurrent cancers most commonly presented as symptomatic masses (15/31) (p=0.028).
CONCLUSION
Most recurrent breast cancers showed the same cancer subtype as the primary tumor, and recurrent breast cancer subtypes correlated with the detection modality. Imaging surveillance of survivors of breast cancer might be more beneficial in cases of HR+HER2− type breast cancer or HER2+ type breast cancer than in cases of triple-negative type breast cancer.

Keyword

Breast neoplasms; ErbB-2; Follow-up studies; Recurrence

MeSH Terms

Breast Neoplasms*
Breast*
Disease-Free Survival
Female
Follow-Up Studies
Humans
Immunohistochemistry
Lymph Nodes
Mammography
Methods*
Receptor, Epidermal Growth Factor
Recurrence
Survivors*
Thoracic Wall
Ultrasonography
Receptor, Epidermal Growth Factor

Reference

1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015; 65:87–108.

2. Garne JP, Aspegren K, Balldin G, Ranstam J. Increasing incidence of and declining mortality from breast carcinoma: trends in Malmö, Sweden, 1961-1992. Cancer. 1997; 79:69–74.

3. Otten JD, Broeders MJ, Fracheboud J, Otto SJ, de Koning HJ, Verbeek AL. Impressive time-related influence of the Dutch screening programme on breast cancer incidence and mortality, 1975-2006. Int J Cancer. 2008; 123:1929–1934.

4. Independent UK Panel on Breast Cancer Screening. The benefits and harms of breast cancer screening: an independent review. Lancet. 2012; 380:1778–1786.

5. National Cancer Center. Ministry of Health and Welfare. Korea Central Cancer Registry. Annual Report of Cancer Statistics in Korea in 2012. Goyang: National Cancer Center;2014.

6. Soerjomataram I, Louwman MW, Ribot JG, Roukema JA, Coebergh JW. An overview of prognostic factors for long-term survivors of breast cancer. Breast Cancer Res Treat. 2008; 107:309–330.

7. Lowery AJ, Kell MR, Glynn RW, Kerin MJ, Sweeney KJ. Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res Treat. 2012; 133:831–841.

8. Senkus E, Kyriakides S, Penault-Llorca F, Poortmans P, Thompson A, Zackrisson S, et al. Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013; 24:Suppl 6. vi7–vi23.

9. Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, et al. American Cancer Society/American Society of Clinical Oncology breast cancer survivorship care guideline. J Clin Oncol. 2016; 34:611–635.

10. Yoon JH, Kim MJ, Kim EK, Moon HJ. Imaging surveillance of patients with breast cancer after primary treatment: current recommendations. Korean J Radiol. 2015; 16:219–228.

11. Berg WA, Zhang Z, Lehrer D, Jong RA, Pisano ED, Barr RG, et al. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA. 2012; 307:1394–1404.

12. Kim MJ, Kim EK, Kwak JY, Park BW, Kim SI, Sohn J, et al. Role of sonography in the detection of contralateral metachronous breast cancer in an Asian population. AJR Am J Roentgenol. 2008; 190:476–480.

13. Kim MJ, Kim EK, Kwak JY, Park BW, Kim SI, Sohn J, et al. Sonographic surveillance for the detection of contralateral metachronous breast cancer in an Asian population. AJR Am J Roentgenol. 2009; 192:221–228.

14. American College of Radiology, BI-RADS Committee. ACR BI-RADS Atlas: Breast Imaging Reporting and Data System. 5th ed. Reston: American College of Radiology;2013.

15. Spitale A, Mazzola P, Soldini D, Mazzucchelli L, Bordoni A. Breast cancer classification according to immunohistochemical markers: clinicopathologic features and short-term survival analysis in a population-based study from the South of Switzerland. Ann Oncol. 2009; 20:628–635.

16. Wolff AC, Hammond ME, Hicks DG, Dowsett M, McShane LM, Allison KH, et al. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. J Clin Oncol. 2013; 31:3997–4013.

17. Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, et al. Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res. 2007; 13(15 Pt 1):4429–4434.

18. Kim SJ, Chung SY, Chang JM, Cho N, Han W, Moon WK. Ultrasound screening of contralateral breast after surgery for breast cancer. Eur J Radiol. 2015; 84:54–60.

19. Kim SJ, Moon WK, Cho N, Chang JM. The detection of recurrent breast cancer in patients with a history of breast cancer surgery: comparison of clinical breast examination, mammography and ultrasonography. Acta Radiol. 2011; 52:15–20.

20. Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Böhm-Vélez M, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA. 2008; 299:2151–2163.

21. Kimbung S, Kovács A, Danielsson A, Bendahl PO, Lövgren K, Frostvik Stolt M, et al. Contrasting breast cancer molecular subtypes across serial tumor progression stages: biological and prognostic implications. Oncotarget. 2015; 6:33306–33318.

22. Shin HJ, Kim HH, Huh MO, Kim MJ, Yi A, Kim H, et al. Correlation between mammographic and sonographic findings and prognostic factors in patients with node-negative invasive breast cancer. Br J Radiol. 2011; 84:19–30.

23. Mazurowski MA, Zhang J, Grimm LJ, Yoon SC, Silber JI. Radiogenomic analysis of breast cancer: luminal B molecular subtype is associated with enhancement dynamics at MR imaging. Radiology. 2014; 273:365–372.

24. Kawashima H, Inokuchi M, Furukawa H, Kitamura S. Triple-negative breast cancer: are the imaging findings different between responders and nonresponders to neoadjuvant chemotherapy? Acad Radiol. 2011; 18:963–969.

25. Elias SG, Adams A, Wisner DJ, Esserman LJ, van't Veer LJ, Mali WP, et al. Imaging features of HER2 overexpression in breast cancer: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014; 23:1464–1483.

26. Dogan BE, Turnbull LW. Imaging of triple-negative breast cancer. Ann Oncol. 2012; 23:Suppl 6. vi23–vi29.

27. Bae MS, Han W, Koo HR, Cho N, Chang JM, Yi A, et al. Characteristics of breast cancers detected by ultrasound screening in women with negative mammograms. Cancer Sci. 2011; 102:1862–1867.