| 1. Green LA, Karow JA, Toman JE, Lostumbo A, Xie K. Review of breast augmentation and reconstruction for the radiologist with emphasis on MRI. [Review]. Clin Imaging. 47:101-117, 2018 Jan - Feb. |
Review/Other-Dx |
N/A |
To review imaging of the augmented and reconstructed breast, as well as complications, with a focus on Magnetic Resonance Imaging (MRI). |
No results stated in abstract. |
4 |
| 2. Kummerow KL, Du L, Penson DF, Shyr Y, Hooks MA. Nationwide trends in mastectomy for early-stage breast cancer. JAMA Surgery. 150(1):9-16, 2015 Jan. |
Review/Other-Dx |
1.2 million women |
To examine whether mastectomy rates in patients eligible for breast conservation surgery (BCS) are increasing over time nationwide, and are associated with coincident increases in breast reconstruction and bilateral mastectomy for unilateral disease. |
A total of 35.5% of the study cohort underwent mastectomy. The adjusted odds of mastectomy in BCS-eligible women increased 34% during the most recent 8 years of the cohort, with an odds ratio of 1.34 (95% CI, 1.31-1.38) in 2011 relative to 2003. Rates of increase were greatest in women with clinically node-negative disease (odds ratio, 1.38; 95% CI, 1.34-1.41) and in situ disease (odds ratio, 2.05; 95% CI, 1.95-2.15). In women undergoing mastectomy, rates of breast reconstruction increased from 11.6% in 1998 to 36.4% in 2011 (P?<?.001 for trend). Rates of bilateral mastectomy for unilateral disease increased from 1.9% in 1998 to 11.2% in 2011 (P?<?.001). |
4 |
| 3. Panchal H, Pilewskie ML, Sheckter CC, et al. National trends in contralateral prophylactic mastectomy in women with locally advanced breast cancer. Journal of Surgical Oncology. 119(1):79-87, 2019 Jan. |
Observational-Dx |
23,943 women |
To estimate national contralateral prophylactic mastectomy (CPM) trends in women with unilateral cT4M0 breast cancer. |
Of 23,943 women, 41% had T4abc disease and 35% T4d. Cumulative CPM rates were 15%, 23%, and 18%, for the T4abc, T4d, and all T4 groups, respectively. Trend analysis revealed a significant upsurge in CPM demonstrating 12% annual growth for T4abc tumors, 8% for T4d and 9% for all T4 (all P?<?0.001). |
4 |
| 4. Zakhireh J, Fowble B, Esserman LJ. Application of screening principles to the reconstructed breast. [Review] [94 refs]. J Clin Oncol. 28(1):173-80, 2010 Jan 01. |
Review/Other-Dx |
N/A |
To detail the reasons that should allow clinicians to forego routine surveillance imaging in the majority of women who undergo mastectomy and reconstruction. |
No results stated in abstract. |
4 |
| 5. Medina-Franco H, Vasconez LO, Fix RJ, et al. Factors associated with local recurrence after skin-sparing mastectomy and immediate breast reconstruction for invasive breast cancer. Ann Surg. 235(6):814-9, 2002 Jun. |
Review/Other-Dx |
173 patients |
To examine the incidence of local recurrence (LR) and factors associated with it in a population of patients who underwent skin-sparing mastectomy (SSM) and immediate reconstruction for invasive carcinoma. |
Mean patient age was 47 +/- 9 years (27% were 40 or younger). The AJCC stages were 1 = 43%, 2 = 52%, and 3 = 5%. Thirty percent of tumors were poorly differentiated. With a median follow-up of 73 months, the LR rate was 4.5%. The mean local relapse-free interval was 26 months. Seventy-five percent of patients who presented with LR developed distant metastases and died of disease within a mean of 21 months. On univariate analysis, factors associated with higher LR rate were tumor stage 2 or 3, tumor size larger than 2 cm, node-positive disease, and poor tumor differentiation. Actuarial 1-, 3-, and 5-year overall survival rates were 98%, 94%, and 88%, respectively. On multivariate analysis, factors associated with decreased survival were advanced stage, presence of LR, and absence of hormone therapy. LR was a highly significant predictor of tumor-related death. |
4 |
| 6. Kaoutzanis C, Xin M, Ballard TN, et al. Autologous Fat Grafting After Breast Reconstruction in Postmastectomy Patients: Complications, Biopsy Rates, and Locoregional Cancer Recurrence Rates. Ann Plast Surg. 76(3):270-5, 2016 Mar. |
Observational-Dx |
108 women |
To assess outcomes of autologous fat grafting after breast reconstruction in postmastectomy patients. |
Between January 2008 and July 2013, 108 women and a total of 167 breast reconstructions underwent autologous fat grafting for revision of postmastectomy breast reconstruction. Their ages ranged from 22 to 71 years (mean, 48 years). Fat grafts were harvested, processed, and injected using the Coleman technique. The mean number of fat grafting procedures was 1.3 (range, 1-4) per breast. Follow-up ranged from 6 to 57 months (mean, 20.2 months). Fifty-three (31.7%) breasts underwent imaging after autologous fat grafting. Suspicious imaging findings requiring biopsy were discovered in 4 (2.4%) breasts, and clinically palpable lesions combined with suspicious imaging findings requiring biopsy were present in another 4 (2.4%) breasts. All 8 biopsies showed fat necrosis, scar, or oil cysts without evidence of malignancy. One (0.6%) local complication (a wound infection at the recipient site requiring oral antibiotics) after autologous fat grafting was reported. During the limited follow-up period, there were no locoregional cancer recurrences. |
3 |
| 7. Adrada BE, Whitman GJ, Crosby MA, Carkaci S, Dryden MJ, Dogan BE. Multimodality Imaging of the Reconstructed Breast. [Review]. Curr Probl Diagn Radiol. 44(6):487-95, 2015 Nov-Dec. |
Review/Other-Dx |
N/A |
To illustrate the imaging characteristics and pathologic findings associated with various types of breast reconstruction in women who have undergone mastectomy to treat breast cancer. |
No results stated in abstract. |
4 |
| 8. Fajardo LL, Roberts CC, Hunt KR. Mammographic surveillance of breast cancer patients: should the mastectomy site be imaged?. AJR. American Journal of Roentgenology. 161(5):953-5, 1993 Nov. |
Observational-Dx |
827 patients |
To evaluate the usefulness of routine mammography of the mastectomy site in women who have been treated for breast carcinoma. |
Local recurrences of breast cancer were seen in 39 (4.5%) of the 859 breasts in the study group. All patients had a physical examination of the breast and mammography within 3 months of the diagnosis of recurrent breast carcinoma. Mammography of the mastectomy site did not show any recurrences that were not suspected on the basis of physical examination. For two of 20 patients, spot-compression views of palpable abnormalities showed thickening of the surgical scar. In four patients with pain in the chest wall, no abnormalities were found on physical examination or mammograms, but bone scintigrams showed metastasis to the ribs. |
4 |
| 9. McCarthy CM, Pusic AL, Sclafani L, et al. Breast cancer recurrence following prosthetic, postmastectomy reconstruction: incidence, detection, and treatment. Plast Reconstr Surg. 121(2):381-8, 2008 Feb. |
Observational-Dx |
608 patients |
To evaluate the influence of prosthetic reconstruction on the incidence, detection, and management of locoregional recurrence following mastectomy for invasive breast cancer. |
In total, 618 patients who underwent mastectomy for invasive breast cancer from 1995 until 1999 were evaluated. Three hundred nine patients who had immediate, tissue expander/implant reconstruction were matched to 309 women who underwent mastectomy alone on the basis of age (+/- 5 years) and breast cancer stage (I, II, or III). The incidence of locoregional recurrence following mastectomy was 6.8 percent in patients who had reconstruction and 8.1 percent in patients who had mastectomy alone (log rank p=0.6015). Median time to detection of a locoregional recurrence was 2.3 years (range, 0.1 to 7.2 years) in the reconstructed cohort and 1.9 years (range, 0.1 to 8.8 years) in the nonreconstructed cohort (p = 0.733). Permanent implants were removed following infection in one patient and patient request in two. |
2 |
| 10. Noroozian M, Carlson LW, Savage JL, et al. Use of Screening Mammography to Detect Occult Malignancy in Autologous Breast Reconstructions: A 15-year Experience. Radiology. 289(1):39-48, 2018 10. |
Observational-Dx |
515 women |
To examine how often screening mammography depicts clinically occult malignancy in breast reconstruction with autologous myocutaneous flaps (AMFs). |
An average of 6.7 screening mammograms (range, 1-16) were obtained over 15.5 years. The frequency of local-regional recurrence (LRR) was 3.9% (20 of 515 women; 95% confidence interval [CI]: 2.2%, 5.6%); all LRRs were invasive, and none were detected in the breast mound after prophylactic mastectomy. Of the 20 women with LRR, 13 (65%) were screened annually before the diagnosis. Seven of those 13 women (54%) had clinically occult LRR, and mammography depicted five. Five of the six clinically evident recurrences (83%) were interval cancers. The median time between reconstruction and first recurrence was 4.4 years (range, 0.8-16.2 years). The CDR per AMF was 1.5 per 1000 screening mammograms (five of 3358; 95% CI: 0.18, 2.8) after mastectomy for cancer and 0 of 1000 examinations (0 of 805 mammograms; 95% CI: 0, 5) after prophylactic mastectomy. Sensitivity, specificity, positive predictive value, and false-positive biopsy rate were 42% (five of 12), 99.4% (4125 of 4151), 16% (five of 31), and 0.6% (26 of 4151), respectively. |
4 |
| 11. Patterson SG, Teller P, Iyengar R, et al. Locoregional recurrence after mastectomy with immediate transverse rectus abdominis myocutaneous (TRAM) flap reconstruction. Ann Surg Oncol. 19(8):2679-84, 2012 Aug. |
Observational-Dx |
390 patients |
To identify characteristics of locoregional recurrence (LRR) after transverse rectus abdominis myocutaneous (TRAM) reconstruction. |
We identified 18 LRR (4.6 %) in 18 of 390 patients who underwent immediate TRAM reconstructions for breast cancer from 1998 to 2008. The median follow-up was 69.2 months. The mean age at time of mastectomy was 49.5 years. All LRR were detected by physical examination. The LRR occurred in the TRAM subcutaneous tissue (n = 9), five in the ipsilateral axillary lymph node and four in the supraclavicular lymph node. Of the 18 patients who developed LRR, 14 (77.7 %) presented with stage 0-1-2 and 4 (22.2 %) with stage 3 disease at the time of the original mastectomy. The average time for a LRR to present was 35.8 months after initial mastectomy and reconstruction. For patients who initially presented with stage 3 disease, the average time to LRR was shorter (22.9 months). Nine patients (50.0 %) were found to have metastatic disease at the time of the LRR, and 6 (33.3 %) died of disease. |
4 |
| 12. Romics L Jr, Chew BK, Weiler-Mithoff E, et al. Ten-year follow-up of skin-sparing mastectomy followed by immediate breast reconstruction. Br J Surg. 99(6):799-806, 2012 Jun. |
Observational-Tx |
253 patients |
To determine the rates of local, locoregional and distant recurrence across the broad spectrum of indications for mastectomy. |
Follow-up data from 253 consecutive patients with IBR were reviewed. Patients with incomplete follow-up data and those undergoing SSM for recurrent disease following previous lumpectomy were disregarded, leaving 207 for analysis. Offering IBR to all women requiring mastectomy resulted in a large proportion of patients with advanced disease.During a median follow-up of 119 months, 17 (8·2 per cent) locoregional, six (2·9 per cent) local and 22 (10·6 per cent) distant recurrences were detected; the overall recurrence rate was 39 (18·8 per cent). Overall recurrence rate was associated with axillary lymph node metastasis (P = 0·009), higher stage (P < 0·001) and higher tumour grade (P = 0·031). The breast cancer-specific survival rate was 90·8 per cent (19 of 207 women died from recurrence). |
2 |
| 13. Warren Peled A, Foster RD, Stover AC, et al. Outcomes after total skin-sparing mastectomy and immediate reconstruction in 657 breasts. Ann Surg Oncol. 19(11):3402-9, 2012 Oct. |
Observational-Dx |
428 patients |
To review outcomes of patients undergoing total skin-sparing mastectomy (TSSM). |
TSSM was performed on 657 breasts in 428 patients. Indications included in situ cancer [111 breasts (16.9%)], invasive cancer [301 breasts (45.8%)], and prophylactic risk-reduction [245 breasts (37.3%)]. A total of 210 patients (49%) had neoadjuvant chemotherapy, 78 (18.2%) had adjuvant chemotherapy, and 114 (26.7%) had postmastectomy radiotherapy. Nipple tissue contained in situ cancer in 11 breasts (1.7%) and invasive cancer in 9 breasts (1.4%); management included repeat excision (7 cases), NAC removal (9 cases), or radiotherapy without further excision (4 cases). Ischemic complications included 13 cases (2%) of partial nipple loss, 10 cases (1.5%) of complete nipple loss, and 78 cases (11.9%) of skin flap necrosis. Overall locoregional recurrence rate was 2% (median follow-up 28 months), with a 2.4% rate observed in the subset of patients with at least 3 years' follow-up (median 45 months). No NAC skin recurrences were observed. |
4 |
| 14. Hedegard W, Niell B, Specht M, Winograd J, Rafferty E. Breast reconstruction with a deep inferior epigastric perforator flap: imaging appearances of the normal flap and common complications. AJR Am J Roentgenol. 200(1):W75-84, 2013 Jan. |
Review/Other-Dx |
N/A |
To illustrate the normal imaging appearance of deep inferior epigastric perforator (DIEP) flap breast reconstruction and common postoperative complications. |
No results stated in abstract. |
4 |
| 15. Mainiero MB, Moy L, Baron P, et al. ACR Appropriateness Criteria® Breast Cancer Screening. J Am Coll Radiol 2017;14:S383-S90. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for breast cancer screening. |
No results stated in abstract. |
4 |
| 16. Rissanen TJ, Makarainen HP, Mattila SI, Lindholm EL, Heikkinen MI, Kiviniemi HO. Breast cancer recurrence after mastectomy: diagnosis with mammography and US. Radiology. 188(2):463-7, 1993 Aug. |
Observational-Dx |
67 patients |
To evaluate the usefulness of mammography and US for the diagnosis of local and regional breast cancer recurrences after mastectomy. |
The authors reviewed mammograms and/or ultrasound (US) scans of 76 lesions (67 patients) suspected of being recurrent breast cancer. All patients had previously undergone mastectomy. Sixty-one cases were malignant disease and 15 were benign. Mammography and US were complementary to clinical examination in evaluating palpable lesions at the mastectomy site. Both imaging methods revealed nonpalpable recurrences. The sensitivity of US was 91%, whereas the sensitivities of clinical examination and mammography were 79% and 45%, respectively. US was the best imaging method for evaluating tumors in the chest wall far from the scar and in the axilla, as these could not be visualized on mammograms. |
3 |
| 17. Monticciolo DL, Newell MS, Moy L, Niell B, Monsees B, Sickles EA. Breast Cancer Screening in Women at Higher-Than-Average Risk: Recommendations From the ACR. Journal of the American College of Radiology. 15(3 Pt A):408-414, 2018 03. |
Review/Other-Dx |
N/A |
To provide recommendations for breast cancer screening in women at higher-than-average-risk. |
No results stated in abstract. |
4 |
| 18. Yilmaz MH, Esen G, Ayarcan Y, et al. The role of US and MR imaging in detecting local chest wall tumor recurrence after mastectomy. Diagn Interv Radiol. 13(1):13-8, 2007 Mar. |
Observational-Dx |
27 patients |
To determine the role of clinical examination, ultrasonography (US), and magnetic resonance imaging (MRI) in detecting local tumor recurrence in patients who underwent modified radical mastectomy for breast cancer. |
Of the 10 cases that underwent biopsy secondary to suspicious lesions for malignancy according to MRI findings, 7 were found to have recurrence. In the remaining 3 patients, recurrence diagnosis was made based on the fact that the lesions regressed in response to chemotherapy. In 17 cases, there were no suspicious findings on MRI for local recurrence. In 2 of these cases, biopsies were performed due to suspicious US findings; however, no malignancies were detected. The sensitivity and specificity of clinical examination in detecting local recurrence was 70% and 35.2%, respectively. These values were 90% and 88.2% for US, and 100% and 100% for MRI. |
3 |
| 19. Kim HJ, Kwak JY, Choi JW, et al. Impact of US surveillance on detection of clinically occult locoregional recurrence after mastectomy for breast cancer. Ann Surg Oncol. 17(10):2670-6, 2010 Oct. |
Observational-Dx |
874 patients |
To investigate the efficacy of locoregional ultrasonography (LRUS) for the detection of recurrence in asymptomatic patients who underwent mastectomy and the impact of LRUS on prognosis. |
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). |
3 |
| 20. Lee JH, Kim EK, Oh JY, et al. US screening for detection of nonpalpable locoregional recurrence after mastectomy. Eur J Radiol. 82(3):485-9, 2013 Mar. |
Observational-Dx |
468 patients |
To assess the value of screening ultrasonography (US) in the detection of nonpalpable locoregional recurrence following mastectomy for breast cancer and to describe the US appearances of occult recurrent cancers. |
Of the 468 patients assessed, 19 (4.1%) showed "suspicious for malignant nodules"; of these lesions, 10 were malignant. One false-negative case was identified. The sensitivity and specificity were 90.9% and 98.0%, respectively. A biopsy positive predictive value of 52.6% was observed. Cancer detection rates were 2.1% with US screenings of mastectomy sites and ipsilateral axillary fossae. The common US features of occult recurrences at the mastectomy sites were irregular shaped, not-circumscribed marginated, and hypoechoic masses with intratumoral vascularities. The most common location was within the deep muscle layer. |
3 |
| 21. Greenberg JS, Javitt MC, Katzen J, Michael S, Holland AE. Clinical performance metrics of 3D digital breast tomosynthesis compared with 2D digital mammography for breast cancer screening in community practice. AJR. American Journal of Roentgenology. 203(3):687-93, 2014 Sep. |
Observational-Dx |
3D DBT (n = 23,149 patients) versus 2D DM (n = 54,684 patients) |
To assess the clinical performance of combined 2D-3D digital breast tomosynthesis (DBT), referred to as "3D DBT," compared with 2D digital mammography (DM) alone for screening mammography in a community-based radiology practice. |
For patients screened with 3D DBT, the relative change in recall rate was 16.1% lower than for patients screened with 2D DM (p > 0.0001). The overall cancer detection rate (CDR), expressed as number of cancers per 1000 patients screened, was 28.6% greater (p = 0.035) for 3D DBT (6.3/1000) compared with 2D DM (4.9/1000). The CDR for invasive cancers with 3D DBT (4.6/1000) was 43.8% higher (p = 0.0056) than with 2D DM (3.2/1000). The positive predictive value for recalls from screening (PPV1) was 53.3% greater (p = 0.0003) for 3D DBT (4.6%) compared with 2D DM (3.0%). No significant difference in the positive predictive value for biopsy (PPV3) was found for 3D DBT versus 2D DM (22.8% and 23.8%, respectively) (p = 0.696). |
3 |
| 22. Friedewald SM, Rafferty EA, Rose SL, et al. Breast cancer screening using tomosynthesis in combination with digital mammography. JAMA. 311(24):2499-507, 2014 Jun 25. |
Observational-Dx |
454,850 examinations |
To determine if mammography combined with tomosynthesis is associated with better performance of breast screening programs in the United States. |
A total of 454,850 examinations (n=281,187 digital mammography; n=173,663 digital mammography + tomosynthesis) were evaluated. With digital mammography, 29,726 patients were recalled and 5056 biopsies resulted in cancer diagnosis in 1207 patients (n=815 invasive; n=392 in situ). With digital mammography + tomosynthesis, 15,541 patients were recalled and 3285 biopsies resulted in cancer diagnosis in 950 patients (n=707 invasive; n=243 in situ). Model-adjusted rates per 1000 screens were as follows: for recall rate, 107 (95% CI, 89-124) with digital mammography vs 91 (95% CI, 73-108) with digital mammography + tomosynthesis; difference, -16 (95% CI, -18 to -14; P < .001); for biopsies, 18.1 (95% CI, 15.4-20.8) with digital mammography vs 19.3 (95% CI, 16.6-22.1) with digital mammography + tomosynthesis; difference, 1.3 (95% CI, 0.4-2.1; P = .004); for cancer detection, 4.2 (95% CI, 3.8-4.7) with digital mammography vs 5.4 (95% CI, 4.9-6.0) with digital mammography + tomosynthesis; difference, 1.2 (95% CI, 0.8-1.6; P < .001); and for invasive cancer detection, 2.9 (95% CI, 2.5-3.2) with digital mammography vs 4.1 (95% CI, 3.7-4.5) with digital mammography + tomosynthesis; difference, 1.2 (95% CI, 0.8-1.6; P < .001). The in situ cancer detection rate was 1.4 (95% CI, 1.2-1.6) per 1000 screens with both methods. Adding tomosynthesis was associated with an increase in the positive predictive value for recall from 4.3% to 6.4% (difference, 2.1%; 95% CI, 1.7%-2.5%; P < .001) and for biopsy from 24.2% to 29.2% (difference, 5.0%; 95% CI, 3.0%-7.0%; P < .001). |
3 |
| 23. Caumo F, Bernardi D, Ciatto S, et al. Incremental effect from integrating 3D-mammography (tomosynthesis) with 2D-mammography: Increased breast cancer detection evident for screening centres in a population-based trial. BREAST. 23(1):76-80, 2014 Feb. |
Observational-Dx |
57 subjects, 59 breast cancers |
To examine centre-specific effect of integrated 2D/3D mammography based on the STORM (screening with tomosynthesis or standard mammography) trial. |
Of 33 cancers detected in Trento, 21 were detected at both 2D and 2D/3D screening, 12 cancers were detected only with integrated 2D/3D screening compared with none detected at 2D-only screening (P < 0.001). Of the 26 cancers detected in Verona, 18 were detected at both 2D and 2D/3D screening, 8 cancers were detected only with integrated 2D/3D screening compared with none detected at 2D-only screening (P = 0.008). There were no differences between centres in baseline CDR, and incremental CDR attributable to 3D-mammography was similar for Trento (2.8/1000 screens) and for Verona (2.6/1000 screens). Trento had 239 FPR (5.7% of screens): 103 FPR at both screen-readings, 93 FPR only at 2D-mammography compared with 43 FPR only at 2D/3D-mammography (p < 0.001). Verona had 156 FPR (5.2% of screens): 78 FPR at both screen-readings, 48 FPR only at 2D-mammography compared with 30 FPR only at 2D/3D-mammography (p = 0.054). Estimated reduction in FPR proportion had recall been conditional to 2D/3D-mammography-positivity differed between centres (21.0% versus 11.5%; P = 0.02). |
1 |
| 24. Bernardi D, Ciatto S, Pellegrini M, et al. Application of breast tomosynthesis in screening: incremental effect on mammography acquisition and reading time. Br J Radiol. 2012;85(1020):e1174-1178. |
Observational-Dx |
10 cancers and 90 negative controls |
To supplement the paucity of information available on logistical aspects of the application of three-dimensional (3D) mammography in breast screening. |
Average acquisition time (measured from start of first-view breast positioning to compression release at completion of last view) for seven radiographers, based on 20 screening examinations, was longer for 2D+3D (4 min 3 s; range 3 min 53 s-4 min 18 s) than 2D mammography (3 min 13 s; range 3 min 0 s-3 min 26 s; p<0.01). Average radiologists' reading time per screening examination (three radiologists reading case-mix of 100 screens: 10 cancers, 90 controls) was longer for 2D+3D (77 s; range 60-90 s) than for 2D mammography (33 s; range 25-46 s; p<0.01). 2D+3D screen-reading was associated with detection of more cancers and with substantially fewer recalls than 2D mammography alone. |
2 |
| 25. Bernardi D, Caumo F, Macaskill P, et al. Effect of integrating 3D-mammography (digital breast tomosynthesis) with 2D-mammography on radiologists' true-positive and false-positive detection in a population breast screening trial. European Journal of Cancer. 50(7):1232-8, 2014 May. |
Experimental-Dx |
7,292 participants |
To report an evaluation of the effect of integrating 3D-mammography with 2D-mammography for breast screening on individual radiologists’ true-positive (TP) and FP detection, based on radiologists who participated in the STORM trial. |
There were 59 cancers and 395 false recalls amongst 7292 screening participants. At 2D-mammography screening, radiologist-specific TP detection ranged between 38% and 83% (median 63%; mean 60% and sd 15.4%); at integrated 2D/3D-mammography, TP detection ranged between 78% and 93% (median 87%; mean 87% and sd 5.2%). For all but one radiologist, 2D/3D-mammography improved breast cancer detection (relative to 2D-mammography) ranging between 0% and 54% (median 29%; mean 27% and sd 16.2%) increase in the proportion of detected cancers. Incremental CDR attributable to integrating 3D-mammography in screening varied between 0/1000 and 5.3/1000 screens (median 1.8/1000; mean 2.3/1000 and sd 1.6/1000). Radiologist-specific FPR for 2D-mammography ranged between 1.5% and 4.2% (median 3.1%; mean 2.9% and sd 0.87%), and FPR based on the integrated 2D/3D-mammography read ranged between 1.0% and 3.3% (median 2.4%; mean 2.2% and sd 0.72%). Integrated 2D/3D-mammography screening, relative to 2D-mammography, had the effect of reducing FP and increasing TP detection for most radiologists |
1 |
| 26. Ciatto S, Houssami N, Bernardi D, et al. Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): a prospective comparison study. Lancet Oncol. 14(7):583-9, 2013 Jun. |
Experimental-Dx |
7292 women |
To investigate the effect of integrated 2D and 3D mammography in population breast-cancer screening. |
7292 women were screened (median age 58 years [IQR 54-63]). We detected 59 breast cancers (including 52 invasive cancers) in 57 women. Both 2D and integrated 2D and 3D screening detected 39 cancers. We detected 20 cancers with integrated 2D and 3D only versus none with 2D screening only (p<0.0001). Cancer detection rates were 5.3 cancers per 1000 screens (95% CI 3.8-7.3) for 2D only, and 8.1 cancers per 1000 screens (6.2-10.4) for integrated 2D and 3D screening. The incremental cancer detection rate attributable to integrated 2D and 3D mammography was 2.7 cancers per 1000 screens (1.7-4.2). 395 screens (5.5%; 95% CI 5.0-6.0) resulted in false positive recalls: 181 at both screen reads, and 141 with 2D only versus 73 with integrated 2D and 3D screening (p<0.0001). We estimated that conditional recall (positive integrated 2D and 3D mammography as a condition to recall) could have reduced false positive recalls by 17.2% (95% CI 13.6-21.3) without missing any of the cancers detected in the study population. |
1 |
| 27. Helvie MA, Bailey JE, Roubidoux MA, et al. Mammographic screening of TRAM flap breast reconstructions for detection of nonpalpable recurrent cancer. Radiology. 224(1):211-6, 2002 Jul. |
Observational-Dx |
113 women |
To evaluate findings from routine mammographic screenings in patients with transverse rectus abdominis musculocutaneous (TRAM) flap reconstructions. |
Seven (3%) of 214 examinations were BI-RADS category 4 or 5. Six (86%) of seven patients underwent biopsy. Two (33%) of these six biopsies demonstrated invasive ductal carcinoma. Cancer detection rate for mammography was 1.9% (two of 106) (95% CI: 0.33%, 7.32%) for women with reconstruction for breast cancer during the 2-year period. One (6%) of 16 BI-RADS category 3 examinations later proved to be invasive ductal carcinoma at follow-up. No interval cancer was discovered in 171 cases of BI-RADS category 1 or 2 examinations with 1-year follow-up. No cancers occurred in women who underwent prophylactic mastectomy. A biopsy positive predictive value of 33% (95% CI: 6%, 76%) was observed. |
3 |
| 28. Freyvogel M, Padia S, Larson K, et al. Screening mammography following autologous breast reconstruction: an unnecessary effort. Ann Surg Oncol. 21(10):3256-60, 2014 Oct. |
Observational-Dx |
615 patients |
To establish the true benefit of screening mammography in patients with autologous reconstruction. |
A total of 615 patients were identified and followup data were available for 541. Median follow-up from time of reconstruction was 7 years. Twenty-seven patients developed a LRR (5.0 %). Among patients screened with mammography (n = 397), an abnormality led to 25 biopsies in 25 patients, and 2 were malignant (8 %). Among patients receiving routine clinical exam (n = 537), an abnormality led to 77 biopsies in 66 patients, and 30 were malignant (39 %). The median time from cancer surgery to LRR was 2.6 years. LRR was detected on clinical exam in 24 of 27 patients (88.9 %). Screening mammography detected two recurrences that were palpable on follow-up exam. One patient had an incidental chest wall recurrence found on PET/CT. In summary, 26 of 27 (96.3 %) patients had a clinically detectable LRR. |
3 |
| 29. Lee JM, Georgian-Smith D, Gazelle GS, et al. Detecting nonpalpable recurrent breast cancer: the role of routine mammographic screening of transverse rectus abdominis myocutaneous flap reconstructions. Radiology. 248(2):398-405, 2008 Aug. |
Observational-Dx |
264 patients |
To perform a retrospective cohort study to determine the rates of recall and cancer detection and then to develop a decision analytic model to evaluate the effectiveness of routine screening of transverse rectus abdominis myocutaneous (TRAM) flap reconstructions. |
Of 554 mammograms (265 TRAM flap reconstructions), 546 (98.6%) had negative results (Breast Imaging Reporting and Data System category 1 or 2). Eight (1.4%) had positive test results (Breast Imaging Reporting and Data System category 0, 3, 4, or 5). All suspicious lesions underwent biopsy and had benign pathologic results. No interval breast cancers were identified. The detection rate for nonpalpable recurrent breast cancer was 0% (exact 95% confidence interval: 0.0%, 1.4%). According to decision analysis, screening would help detect an estimated 12 additional recurrent cancers per 1000 women screened, providing an additional 1.6 days of life expectancy for the screened cohort. Under base-case conditions, screening of TRAM flap reconstructions is less effective than screening asymptomatic women in their 40s. Sensitivity analysis revealed that a benefit equivalent to that of screening asymptomatic women in their 40s was achievable under conditions related to estimates of screening effectiveness and cancer detection rate. |
3 |
| 30. Al-Khalili R, Wynn RT, Ha R. The Contact Zone: A Common Site of Tumor Recurrence in a Patient Who Underwent Skin-Sparing Mastectomy and Myocutaneous Flap Reconstruction. Curr Probl Diagn Radiol. 45(3):233-4, 2016 May-Jun. |
Review/Other-Dx |
1 patient |
To present a case of recurrent invasive ductal carcinoma along the contact zone between the transverse rectus abdominis myocutaneous (TRAM) flap and the native breast tissue that was incidentally detected on a routine high-risk screening-MRI of the breast in an asymptomatic patient with a history of breast cancer. |
No results stated in abstract. |
4 |
| 31. Rieber A, Schramm K, Helms G, et al. Breast-conserving surgery and autogenous tissue reconstruction in patients with breast cancer: efficacy of MRI of the breast in the detection of recurrent disease. European Radiology. 13(4):780-7, 2003 Apr. |
Observational-Dx |
41 patients |
To evaluate capabilities of MRI of the breast in this group of patients in correlation with clinical, conventional mammographic, and sonographic findings |
Flaps could be distinguished from surrounding residual breast tissue in all cases. Edema and skin thickening in the residual mammary tissue and flap implant were observed in 72.7% of patients undergoing radiation, but in only 15.8% of those not undergoing radiotherapy. The MRI excluded disease recurrence in 4 patients with suspicious mammographic and/or sonographic findings. One instance of multifocal disease recurrence identified at MRI evaded detection with all other imaging techniques used. The MRI returned false-positive findings in three cases. Because of their configuration and contrast medium uptake dynamics and their location immediately adjacent to the contact zone between the flap implant and residual mammary tissue, these findings were impossible to differentiate from a recurrent carcinoma. |
4 |
| 32. Lourenco AP, Moy L, Baron P, et al. ACR Appropriateness Criteria R Breast Implant Evaluation. Journal of the American College of Radiology. 15(5S):S13-S25, 2018 May.J. Am. Coll. Radiol.. 15(5S):S13-S25, 2018 May. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for breast implant evaluation. |
No results stated in abstract. |
4 |
| 33. Vanderwalde LH, Dang CM, Tabrizi R, Saouaf R, Phillips EH. Breast MRI after bilateral mastectomy: is it indicated?. Am Surg. 77(2):180-4, 2011 Feb. |
Observational-Dx |
48 women |
To evaluate breast MRI after bilateral mastectomy. |
The median time between mastectomy and first MRI was 36 months. MRI was ordered most often by a medical oncologist (71%). Median age at bilateral mastectomy was 49 years (range, 33 to 72 years). Reasons for obtaining MRI included surveillance in 60 (76%), mass in eight (10%), lymph nodes in four (5%), pain in three (4%), and abscess in one (1%). Overall, 68 (86%) MRIs showed benign imaging findings only. Within the surveillance group, six patients had MRIs with findings that changed management; four patients had some residual breast tissue, and two patients had findings outside the breast that were better evaluated by CT or bone scan and were ultimately benign. MRI confirmed locoregional recurrence in two patients with highly suspicious physical findings. |
4 |
| 34. Golan O, Amitai Y, Barnea Y, Menes TS. Yield of surveillance magnetic resonance imaging after bilateral mastectomy and reconstruction: a retrospective cohort study. Breast Cancer Res Treat. 174(2):463-468, 2019 Apr. |
Observational-Dx |
159 women |
To examine the findings on MRI studies of women after bilateral mastectomy and reconstruction. |
One hundred fifty-nine women had 415 surveillance MRI exams. Most (372, 90%) studies were done in women with implant-based reconstruction. Four hundred and five (98%; 95% confidence interval (CI) 96-99%) of the studies were negative. One breast recurrence was found on MRI (cancer detection rate 2.4 per 1000 MRI exams, 95% CI 0.4-13); however, this woman was simultaneously diagnosed with metastatic disease. The false-positive rate was 90% (95% CI 54-99%). During follow-up three women were diagnosed with local recurrence (interval cancer rate 5 per 1000, 95% CI 1.3-17) and 4 women were diagnosed with metastatic disease. |
3 |
| 35. Grinstein O, Krug B, Hellmic M, et al. Residual glandular tissue (RGT) in BRCA1/2 germline mutation carriers with unilateral and bilateral prophylactic mastectomies. Surgical Oncology. 29:126-133, 2019 Jun. |
Observational-Dx |
169 women |
To describe frequency, localization, and volume of RGT after bilateral prophylactic mastectomy (PME), unilateral, PME, and curative mastectoomy using breast MRI; to define risk constellations, in which RGT must be expected more frequently, and to analyze the occurrence of primary breast cancer after PME during clinical follow-up. |
We identified 169 women carrying BRCA1/2 mutations who underwent prophylactic and curative mastectomy: a total of 338 breasts. RGT was found in 128 of the 338 breasts (37.9%). 68 of the 128 breasts (53.1%) were related to bilateral PME, 37 (28.9%) to unilateral PME and 23 (18.0%) to curative mastectomy. RGT was predominantly unifocal and located in the retroareolar breast region. RGT was observed more often after bilateral PME (p?<?0.0001). In this subgroup, the nipple-sparing mastectomy dominated (108 of 136, 79.4%), in contrast to 23 standard mastectomies (23 of 94, 24.5%) in the subgroup of curative mastectomy (23%). There was a trend towards higher amounts of RGT in surgical units with fewer mastectomies performed. During follow-up, two breast cancers were detected after bilateral and unilateral PME, respectively. |
3 |
| 36. Gennaro G, Hendrick RE, Toledano A, et al. Combination of one-view digital breast tomosynthesis with one-view digital mammography versus standard two-view digital mammography: per lesion analysis. Eur Radiol. 2013;23(8):2087-2094. |
Observational-Dx |
463 breasts of 250 patients |
To evaluate the clinical value of combining one-view mammography (cranio-caudal, CC) with the complementary view tomosynthesis (mediolateral-oblique, MLO) in comparison to standard two-view mammography (MX) in terms of both lesion detection and characterization. |
The 463 cases (breasts) reviewed included 258 with one to three lesions each, and 205 with no lesions. The 258 cases with lesions included 77 cancers in 68 breasts and 271 benign lesions to give a total of 348 proven lesions. The combination, DBT(MLO)+MX(CC), was superior to MX (CC+MLO) in both lesion detection (LDF) and lesion characterization (LCF) overall and for benign lesions. DBT(MLO)+MX(CC) was non-inferior to two-view MX for malignant lesions. |
2 |
| 37. Waldherr C, Cerny P, Altermatt HJ, et al. Value of one-view breast tomosynthesis versus two-view mammography in diagnostic workup of women with clinical signs and symptoms and in women recalled from screening. AJR Am J Roentgenol 2013;200:226-31. |
Observational-Dx |
144 women |
To compare the diagnostic value of one-view digital breast tomosynthesis versus two-view full-field digital mammography (FFDM) alone, and versus a combined reading of both modalities. |
Eighty-six of the 144 patients were found to have breast cancer. The BI-RADS categories for one-view digital breast tomosynthesis were significantly better than those for two-view FFDM (p < 0.001) and were equal to those of the combined reading in both women admitted for diagnostic workup and women recalled from screening. The sensitivity and negative predictive values of digital breast tomosynthesis were superior to those of FFDM in fatty and dense breasts overall and in women admitted for diagnostic workup and in women recalled from screening. Only 11% of digital breast tomosynthesis examinations required additional imaging, compared with 23% of FFDMs. |
3 |
| 38. Yang TL, Liang HL, Chou CP, Huang JS, Pan HB. The adjunctive digital breast tomosynthesis in diagnosis of breast cancer. Biomed Res Int. 2013;2013:597253. |
Observational-Dx |
59 breasts of 57 patients. |
To compare the diagnostic performance of digital breast tomosynthesis (DBT) and digital mammography (DM) for breast cancers. |
A total of 59 breast cancers were reviewed, including 17 (28.8%) mass lesions, 12 (20.3%) focal asymmetry/density, 6 (10.2%) architecture distortion, 23 (39.0%) calcifications, and 1 (1.7%) intracystic tumor. Combo DBT was perceived to be more informative in 58.8% mass lesions, 83.3% density, 94.4% architecture distortion, and only 11.6% calcifications. As to the forced BIRADS score, 84.4% BIRADS 0 on DM was upgraded to BIRADS 4 or 5 on DBT, whereas only 27.3% BIRADS 4A on DM was upgraded on DBT, as BIRADS 4A lesions were mostly calcifications. A significant P value (<0.001) between the BIRADS category and index lesions was noted |
3 |
| 39. Dashevsky BZ, Hayward JH, Woodard GA, Joe BN, Lee AY. Utility and Outcomes of Imaging Evaluation for Palpable Lumps in the Postmastectomy Patient. AJR Am J Roentgenol. 213(2):464-472, 2019 08. |
Observational-Dx |
101 women |
To assess the utility of targeted breast ultrasound and mammography in evaluating palpable lumps in the mastectomy bed. |
Among the 101 patients with a history of prophylactic or therapeutic mastectomy who presented during the study period, 118 palpable cases met the inclusion criteria. All 118 cases were evaluated with ultrasound and 43 with mammography. Among the 75 cases evaluated with ultrasound alone, nine cancers were detected. Among the 43 cases evaluated with both ultrasound and mammography, three cancers were sonographically detected, of which two were mammographically visible and one was mammographically occult. There were two false-negative ultrasound cases; both underwent sampling because of the level of clinical suspicion. In total, 14 palpable lumps in 12 patients were malignant, and 104 palpable lumps in 89 patients were nonmalignant. Targeted ultrasound yielded a negative predictive value (NPV) of 97% and a positive predictive value 2 of 27%. |
3 |
| 40. Usmani S, Khan H, Ahmed N, Marafi F, Garvie N. Scintimammography in conjunction with ultrasonography for local breast cancer recurrence in post-mastectomy breast. British Journal of Radiology. 83(995):934-9, 2010 Nov. |
Experimental-Dx |
41 patients |
To compare the usefulness of (99)Tc(m)-methoxy-isobutyl-isonitrile (MIBI) scintimammography and ultrasonography, alone and in combination, for the detection of chest wall recurrence in the post-mastectomy breast. |
Of the 41 patients, 24 had true positive signs of local breast cancer recurrence upon ultrasonography, 10 were diagnosed as true negatives, a sensitivity of 86%, specificity 77%, positive predictive value (PPV) 89%, negative predictive value (NPV) 71% and accuracy 83% (p = 0.001). By comparison, scintimammography findings were found to be true positive in 25 patients and true negative in 12 patients - sensitivity 89%, specificity 92%, PPV 96%, NPV 80% and accuracy 90% (p = 0.001). Using a combination of these two modalities, the combined sensitivity was 100%, specificity 77%, PPV 90%, NPV 100% and accuracy 93% |
3 |
| 41. Gweon HM, Son EJ, Youk JH, Kim JA, Chung J. Value of the US BI-RADS final assessment following mastectomy: BI-RADS 4 and 5 lesions. Acta Radiol. 53(3):255-60, 2012 Apr 01. |
Observational-Dx |
50 Patients |
To evaluate the diagnostic performance of the American College of Radiology (ACR) ultrasonographic (US) Breast Imaging Reporting and Data System (BI RADS) categories 4 and 5 breast lesions at the mastectomy site |
From 2681 post-mastectomy US examinations, we obtained a study population of 50 patients with 50 lesions (20 palpable, 30 non-palpable). There were nine (45%) malignancies among the palpable lesions and six (20%) malignancies among the non-palpable lesions. The palpability showed no significant correlation with malignancy in overall subcategorization (P .0.05). The PPVs of categories 4 and 5 were 14.3% for category 4a, 62.5% for category 4b, 100% for category 4c, and 100% for category 5. |
3 |
| 42. Edeiken BS, Fornage BD, Bedi DG, Sneige N, Parulekar SG, Pleasure J. Recurrence in autogenous myocutaneous flap reconstruction after mastectomy for primary breast cancer: US diagnosis. Radiology. 227(2):542-8, 2003 May. |
Review/Other-Dx |
20 women |
To assess the value of ultrasonography (US) and US-guided fine-needle aspiration biopsy (FNAB) in the detection and diagnosis of recurrent cancer in breasts reconstructed with autogenous myocutaneous flaps after mastectomy for primary breast cancer and to describe the US appearances of recurrence in the reconstructed breast. |
Twenty-one (54%) of the 39 recurrent cancers depicted at US were clinically occult. Mammography performed in 12 of the 20 patients with reconstructed breasts depicted 14 (56%) of the 25 recurrent cancers that were detected at US in these patients. US-guided FNAB helped to establish a definitive diagnosis of recurrent breast carcinoma in 24 (96%) of the 25 tumor specimens sampled. |
4 |
| 43. Devon RK, Rosen MA, Mies C, Orel SG. Breast reconstruction with a transverse rectus abdominis myocutaneous flap: spectrum of normal and abnormal MR imaging findings. [Review] [29 refs]. Radiographics. 24(5):1287-99, 2004 Sep-Oct. |
Observational-Dx |
22 women |
To investigate the normal MR imaging characteristics of transverse rectus abdominis myocutaneous (TRAM) flap reconstruction, focusing on the anatomic relationship between the reconstructed myocutaneous flap and the adjacent chest wall. To assess the MR imaging appearance of various benign and malignant findings in the TRAM flap reconstructed breast. |
During a 4-year period, 24 neobreasts were imaged in 22 women who had undergone TRAM flap reconstruction after mastectomy. In most of the cases (64%), the indication for MR imaging was a palpable abnormality or pain. In four of 24 cases (17%), recurrent breast cancer was detected. These cases consisted of a local chest wall tumor (n = 2), an infiltrating chest wall tumor (n = 1), and axillary nodal recurrence (n = 1). In all four cases, MR imaging demonstrated a suspicious lesion or abnormality. In 11 of 24 cases (46%), benign findings only were demonstrated. These consisted of localized or diffuse skin thickening, fibrosis, fat necrosis, and seroma. In nine of 24 cases (38%), no pathologic abnormality was identified. |
4 |
| 44. Shellock FG. Reference Manual for Magnetic Resonance Safety, Implants, and Devices: 2019 Edition. Los Angeles, CA: Biomedical Research Publishing Group; 2019. |
Review/Other-Dx |
N/A |
To provide guidelines and recommendations for magnetic resonance safety, implants, and devices. |
No abstract available. |
4 |
| 45. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
