Detection of local recurrence after breast conserving therapy

Abstract EN

The aim of this study is to evaluate the triple assessment (clinical examination, cytology and mammography), magnetic resonance imaging (MRI) in the differentiation of post-treatment changes from local recurrence of breast carcinoma following breast conservation therapy (BCT).

Twenty-five patients treated previously by breast conservation surgery and radiotherapy with clinical suspicion of local recurrence were evaluated prospectively by triple assessment, MRI and open surgical biopsy.

Local recurrence was confirmed histologically in 9 patients.

Of these, mammography identified seven (sensitivity 77.8 %), cytology 6 (sensitivity 66 %) and breast MRI 9 (sensitivity 100 %).

False positive contrast enhancement was seen in two patients (Specificity 87.5 %) in whom histopathology revealed inflammatory changes only.

When triple assessment is inconclusive, MRI is a more accurate technique in diagnosis of recurrence versus scar formation.

However, during the first postoperative year, due to the increased micro vascular fragility and fat necrosis, the interpretation has to be guarded to reduce the number of biopsies and hence the false negative results.