Impact of US Surveillance on Detection of Clinically Occult Locoregional Recurrence after Mastectomy for Breast Cancer

Abstract

This study investigated the efficacy of locoregional ultrasonography (LRUS) for the detection of recurrence in asymptomatic patients who underwent mastectomy and the impact of LRUS on prognosis. A total of 1796 LRUSs were performed in 874 asymptomatic patients who showed no clinical evidence of recurrence after mastectomy. Ultrasonography (US) results were considered positive when US detected any masses at the mastectomy bed or suspicious regional lymph nodes. The final diagnosis of each patient was based on cytopathology results or data collected during the follow-up. The median follow-up was 37 months. We evaluated diagnostic performance of LRUS at the detection of locoregional recurrence (LRR) and compared overall survival of asymptomatic patients with recurrences to that of symptomatic patients with recurrences. Of 874 asymptomatic patients, 57 patients (6.5%) had suspicious LRR on LRUS. The positive predictive value (PPV) of LRUS was 26.3% with 15 recurrences diagnosed in 15 patients (cancer detection rate, 1.7% per patient and 0.8% per examination). Asymptomatic patients with recurrences had better survival compared with symptomatic patients with recurrences (P = .034). LRUS during breast US after mastectomy for breast cancer was helpful for the early detection of recurrence and may lead to a better prognosis for patients.