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Breast
Postoperative and Post-Treatment Imaging
Results Following Treatment for Malignancies
Personal History of Breast Cancer Surveillance
Personal History of Breast Cancer Surveillance
Stamatia Destounis, MD; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Clinical Implications

      • Imaging/Surveillance Recommendations

        TERMINOLOGY

        • Abbreviations

          • Personal history of breast cancer (PHBC)

        • Synonyms

          • Breast-conserving surgery (BCS) = lumpectomy = partial mastectomy

        • Definitions

          • BCS: Surgery with intent to completely remove breast cancer while preserving good cosmetic result
          • Breast-conserving therapy (BCT): BCS followed by radiation therapy (XRT)
            • Equivalent survival rate to mastectomy; indicated for early-stage breast cancer
          • Segmental mastectomy: Excision of entire duct segment
          • Quadrantectomy: Excision of entire quadrant of breast
          • Surveillance: Screening or routine diagnostic mammography to detect local recurrence before symptoms develop
            • Term also used for short-interval follow-up
          • Recurrence: Malignancy consistent of same histopathology as primary breast cancer
            • Most ipsilateral tumors within 5 years represent recurrence, especially within same quadrant as primary
            • Difficult to distinguish from residual tumor especially within 1st year
          • Second primary cancer (SPC): Malignancy arising from residual tissue in either ipsilateral or contralateral breast, but histopathologically distinct from primary cancer
            • Can be difficult to distinguish recurrence from SPC
            • More likely SPC if > 5 years after original diagnosis, contralateral disease, different segment of ipsilateral breast, &/or differing clinical or molecular features
          • Interval cancer: Cancer detected because of symptoms in interval between recommended screens

        CLINICAL IMPLICATIONS

        • Clinical Importance

          IMAGING

          • Mammography/Tomosynthesis 

            • Screening Breast Ultrasound

              • Screening Breast MR

                Imaging Recommendations

                • Best Imaging Tool

                  • Protocol Advice

                    • Epidemiology

                      Selected References

                      1. Choi BH et al: Usefulness of abbreviated breast MRI screening for women with a history of breast cancer surgery. Breast Cancer Res Treat. 167(2):495-502, 2018
                      2. Lowry KP et al: Predictors of surveillance mammography outcomes in women with a personal history of breast cancer. Breast Cancer Res Treat. 171(1):209-215, 2018
                      3. Monticciolo DL et al: Breast cancer screening in women at higher-than-average risk: Recommendations from the ACR. J Am Coll Radiol. 15(3 Pt A):408-414, 2018
                      4. Park VY et al: Breast magnetic resonance imaging for surveillance of women with a personal history of breast cancer: outcomes stratified by interval between definitive surgery and surveillance MR imaging. BMC Cancer. 18(1):91, 2018
                      5. Song SE et al: Diagnostic performances of supplemental breast ultrasound screening in women with personal history of breast cancer. Acta Radiol. 59(5):533-539, 2018
                      6. You JK et al: Can biannual ultrasound surveillance detect smaller second cancers or detect cancers earlier in patients with breast cancer history? Ultrasound Med Biol. 44(7):1355-1363, 2018
                      7. Chu AJ et al: Imaging surveillance for survivors of breast cancer: Correlation between cancer characteristics and method of detection. J Breast Cancer. 20(2):192-7, 2017
                      8. Cho N et al: Breast cancer screening with mammography plus ultrasonography or magnetic resonance imaging in women 50 years or younger at diagnosis and treated with breast conservation therapy. JAMA Oncol. 3(11):1495-502, 2017
                      9. Benveniste AP et al: Surveillance of women with a personal history of breast cancer by tumour subtype. Clin Radiol. 72(3):266.e1-266.e6, 2017
                      10. Moy L et al: ACR Appropriateness Criteria® Stage I breast cancer: initial workup and surveillance for local recurrence and distant metastases in asymptomatic women. J Am Coll Radiol. 14(5S):S282-S292, 2017
                      11. Kim EJ et al: Diagnostic Performance of and Breast Tissue Changes at Early Breast MR Imaging Surveillance in Women after Breast Conservation Therapy. Radiology. 1621-23, 2017
                      12. Lam DL et al: Imaging surveillance after primary breast cancer treatment. AJR Am J Roentgenol. 208(3):676-686, 2017
                      13. Patel BK et al: Variability of postsurgical imaging surveillance of breast cancer patients: a nationwide survey study. AJR Am J Roentgenol. 1-6, 2017
                      14. Lehman CD et al: Screening MRI in women with a personal history of breast cancer. J Natl Cancer Inst. 108(3), 2016
                      15. Gweon HM et al: Breast MR imaging screening in women with a history of breast conservation therapy. Radiology. 272(2):366-73, 2014
                      16. Schacht DV et al: Importance of a personal history of breast cancer as a risk factor for the development of subsequent breast cancer: results from screening breast MRI. AJR Am J Roentgenol. 202(2):289-92, 2014
                      17. Eriksson L et al: Possible influence of mammographic density on local and locoregional recurrence of breast cancer. Breast Cancer Res. 15(4):R56, 2013
                      18. Houssami N et al: Risk factors for second screen-detected or interval breast cancers in women with a personal history of breast cancer participating in mammography screening. Cancer Epidemiol Biomarkers Prev. 22(5):946-61, 2013
                      19. Berg WA 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 307(13):1394-404, 2012
                      20. Arasu VA et al: Benefit of semiannual ipsilateral mammographic surveillance following breast conservation therapy. Radiology. 264(2):371-7, 2012
                      21. Darby S et al: Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378:1707-16, 2011
                      22. Houssami N et al: Accuracy and outcomes of screening mammography in women with a personal history of early-stage breast cancer. JAMA. 2011;305:790-9
                      23. Li J et al: Breast MRI after conservation therapy: usual findings in routine follow-up examinations. Am J Roentgenol. Sep;195(3):799-807, 2010
                      24. Lu WL et al: Impact on survival of early detection of isolated breast recurrences after the primary treatment for breast cancer: a meta-analysis. Breast Cancer Res Treat. 114(3):403-12, 2009
                      25. Krishnamurthy R et al: Mammographic findings after breast conservation therapy. Radiographics. 19 Spec No:S53-62; quiz S262-3, 1999
                      26. Curran J. How effective is mammography in detecting breast cancer recurrence in women after Breast Conservation Therapy (BCT) - A systematic literature review. Radiography 2016; 22 (3): 252-256.
                      27. Sparano JA. Second Breast Cancer: Local Recurrence or New Primary? Medscape Oncology. 2000;3(2)
                      28. Buist DSM et al. Diagnosis of second breast cancer events after initial diagnosis of early stage breast cancer. Breast Cancer Res Treat. 2010;124(3):863-873.
                      29. Huang E, et al. Classifying Local Disease Recurrences after Breast Conservation Therapy Based on Location and Histology. Cancer. 2002; 95(10): 2059-2067.
                      Related Anatomy
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                      Related Differential Diagnoses
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                      References
                      Tables

                      Tables

                      KEY FACTS

                      • Terminology

                        • Clinical Implications

                          • Imaging/Surveillance Recommendations

                            TERMINOLOGY

                            • Abbreviations

                              • Personal history of breast cancer (PHBC)

                            • Synonyms

                              • Breast-conserving surgery (BCS) = lumpectomy = partial mastectomy

                            • Definitions

                              • BCS: Surgery with intent to completely remove breast cancer while preserving good cosmetic result
                              • Breast-conserving therapy (BCT): BCS followed by radiation therapy (XRT)
                                • Equivalent survival rate to mastectomy; indicated for early-stage breast cancer
                              • Segmental mastectomy: Excision of entire duct segment
                              • Quadrantectomy: Excision of entire quadrant of breast
                              • Surveillance: Screening or routine diagnostic mammography to detect local recurrence before symptoms develop
                                • Term also used for short-interval follow-up
                              • Recurrence: Malignancy consistent of same histopathology as primary breast cancer
                                • Most ipsilateral tumors within 5 years represent recurrence, especially within same quadrant as primary
                                • Difficult to distinguish from residual tumor especially within 1st year
                              • Second primary cancer (SPC): Malignancy arising from residual tissue in either ipsilateral or contralateral breast, but histopathologically distinct from primary cancer
                                • Can be difficult to distinguish recurrence from SPC
                                • More likely SPC if > 5 years after original diagnosis, contralateral disease, different segment of ipsilateral breast, &/or differing clinical or molecular features
                              • Interval cancer: Cancer detected because of symptoms in interval between recommended screens

                            CLINICAL IMPLICATIONS

                            • Clinical Importance

                              IMAGING

                              • Mammography/Tomosynthesis 

                                • Screening Breast Ultrasound

                                  • Screening Breast MR

                                    Imaging Recommendations

                                    • Best Imaging Tool

                                      • Protocol Advice

                                        • Epidemiology

                                          Selected References

                                          1. Choi BH et al: Usefulness of abbreviated breast MRI screening for women with a history of breast cancer surgery. Breast Cancer Res Treat. 167(2):495-502, 2018
                                          2. Lowry KP et al: Predictors of surveillance mammography outcomes in women with a personal history of breast cancer. Breast Cancer Res Treat. 171(1):209-215, 2018
                                          3. Monticciolo DL et al: Breast cancer screening in women at higher-than-average risk: Recommendations from the ACR. J Am Coll Radiol. 15(3 Pt A):408-414, 2018
                                          4. Park VY et al: Breast magnetic resonance imaging for surveillance of women with a personal history of breast cancer: outcomes stratified by interval between definitive surgery and surveillance MR imaging. BMC Cancer. 18(1):91, 2018
                                          5. Song SE et al: Diagnostic performances of supplemental breast ultrasound screening in women with personal history of breast cancer. Acta Radiol. 59(5):533-539, 2018
                                          6. You JK et al: Can biannual ultrasound surveillance detect smaller second cancers or detect cancers earlier in patients with breast cancer history? Ultrasound Med Biol. 44(7):1355-1363, 2018
                                          7. Chu AJ et al: Imaging surveillance for survivors of breast cancer: Correlation between cancer characteristics and method of detection. J Breast Cancer. 20(2):192-7, 2017
                                          8. Cho N et al: Breast cancer screening with mammography plus ultrasonography or magnetic resonance imaging in women 50 years or younger at diagnosis and treated with breast conservation therapy. JAMA Oncol. 3(11):1495-502, 2017
                                          9. Benveniste AP et al: Surveillance of women with a personal history of breast cancer by tumour subtype. Clin Radiol. 72(3):266.e1-266.e6, 2017
                                          10. Moy L et al: ACR Appropriateness Criteria® Stage I breast cancer: initial workup and surveillance for local recurrence and distant metastases in asymptomatic women. J Am Coll Radiol. 14(5S):S282-S292, 2017
                                          11. Kim EJ et al: Diagnostic Performance of and Breast Tissue Changes at Early Breast MR Imaging Surveillance in Women after Breast Conservation Therapy. Radiology. 1621-23, 2017
                                          12. Lam DL et al: Imaging surveillance after primary breast cancer treatment. AJR Am J Roentgenol. 208(3):676-686, 2017
                                          13. Patel BK et al: Variability of postsurgical imaging surveillance of breast cancer patients: a nationwide survey study. AJR Am J Roentgenol. 1-6, 2017
                                          14. Lehman CD et al: Screening MRI in women with a personal history of breast cancer. J Natl Cancer Inst. 108(3), 2016
                                          15. Gweon HM et al: Breast MR imaging screening in women with a history of breast conservation therapy. Radiology. 272(2):366-73, 2014
                                          16. Schacht DV et al: Importance of a personal history of breast cancer as a risk factor for the development of subsequent breast cancer: results from screening breast MRI. AJR Am J Roentgenol. 202(2):289-92, 2014
                                          17. Eriksson L et al: Possible influence of mammographic density on local and locoregional recurrence of breast cancer. Breast Cancer Res. 15(4):R56, 2013
                                          18. Houssami N et al: Risk factors for second screen-detected or interval breast cancers in women with a personal history of breast cancer participating in mammography screening. Cancer Epidemiol Biomarkers Prev. 22(5):946-61, 2013
                                          19. Berg WA 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 307(13):1394-404, 2012
                                          20. Arasu VA et al: Benefit of semiannual ipsilateral mammographic surveillance following breast conservation therapy. Radiology. 264(2):371-7, 2012
                                          21. Darby S et al: Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378:1707-16, 2011
                                          22. Houssami N et al: Accuracy and outcomes of screening mammography in women with a personal history of early-stage breast cancer. JAMA. 2011;305:790-9
                                          23. Li J et al: Breast MRI after conservation therapy: usual findings in routine follow-up examinations. Am J Roentgenol. Sep;195(3):799-807, 2010
                                          24. Lu WL et al: Impact on survival of early detection of isolated breast recurrences after the primary treatment for breast cancer: a meta-analysis. Breast Cancer Res Treat. 114(3):403-12, 2009
                                          25. Krishnamurthy R et al: Mammographic findings after breast conservation therapy. Radiographics. 19 Spec No:S53-62; quiz S262-3, 1999
                                          26. Curran J. How effective is mammography in detecting breast cancer recurrence in women after Breast Conservation Therapy (BCT) - A systematic literature review. Radiography 2016; 22 (3): 252-256.
                                          27. Sparano JA. Second Breast Cancer: Local Recurrence or New Primary? Medscape Oncology. 2000;3(2)
                                          28. Buist DSM et al. Diagnosis of second breast cancer events after initial diagnosis of early stage breast cancer. Breast Cancer Res Treat. 2010;124(3):863-873.
                                          29. Huang E, et al. Classifying Local Disease Recurrences after Breast Conservation Therapy Based on Location and Histology. Cancer. 2002; 95(10): 2059-2067.