| 1. Monticciolo DL, Newell MS, Hendrick RE, et al. Breast Cancer Screening for Average-Risk Women: Recommendations From the ACR Commission on Breast Imaging. Journal of the American College of Radiology. 14(9):1137-1143, 2017 Sep. |
Review/Other-Dx |
N/A |
To provide recommendations from the ACR Commission on Breast Imaging on breast cancer screening for average-risk women. |
The ACR recommends annual mammography screening starting at age 40 for women of average risk of developing breast cancer. |
4 |
| 2. Carney PA, Sickles EA, Monsees BS, et al. Identifying minimally acceptable interpretive performance criteria for screening mammography. Radiology 2010;255:354-61. |
Review/Other-Dx |
N/A |
To develop criteria to identify thresholds for minimally acceptable physician performance in interpreting screening mammography studies and to profile the impact that implementing these criteria may have on the practice of radiology in the United States. |
Final cut points to identify low performance were as follows: sensitivity less than 75%, specificity less than 88% or greater than 95%, recall rate less than 5% or greater than 12%, PPV(1) less than 3% or greater than 8%, PPV(2) less than 20% or greater than 40%, and cancer detection rate less than 2.5 per 1000 interpretations. The selected cut points for performance measures would likely result in 18%-28% of interpreting physicians being considered for additional training on the basis of sensitivity and cancer detection rate, while the cut points for specificity, recall, and PPV(1) and PPV(2) would likely affect 34%-49% of practicing interpreters. If underperforming physicians moved into the acceptable range, detection of an additional 14 cancers per 100000 women screened and a reduction in the number of false-positive examinations by 880 per 100000 women screened would be expected. |
4 |
| 3. Heller SL, Lourenco AP, Niell BL, et al. ACR Appropriateness Criteria® Imaging After Mastectomy and Breast Reconstruction. J Am Coll Radiol 2020;17:S403-S14. |
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 imaging after mastectomy and breast reconstruction |
No results stated in abstract. |
4 |
| 4. Visscher DW, Frost MH, Hartmann LC, et al. Clinicopathologic features of breast cancers that develop in women with previous benign breast disease. Cancer. 122(3):378-85, 2016 Feb 01. |
Observational-Dx |
13,485 patients |
To characterize breast cancers developing in a large cohort of women with benign breast disease. |
With median follow-up of 15.8 years, 1273 women developed BC. The majority of BCs were invasive (81%), of which 61% were ductal, 13% were mixed ductal/lobular, and 14% were lobular. Approximately two-thirds of the BC cases were intermediate or high grade, and 29% were lymph node positive. Cancer characteristics were similar across the 3 histologic categories of BBD, with a similar frequency of ductal carcinoma in situ, invasive disease, tumor size, time to invasive BC, histologic type of BC, lymph node positivity, and human epidermal growth factor receptor 2 positivity. Women with atypical hyperplasia were found to have a higher frequency of estrogen receptor-positive BC (91%) compared with women with proliferative disease without atypia (80%) or nonproliferative disease (85%) (P = .02). |
4 |
| 5. Tice JA, Miglioretti DL, Li CS, Vachon CM, Gard CC, Kerlikowske K. Breast Density and Benign Breast Disease: Risk Assessment to Identify Women at High Risk of Breast Cancer. Journal of Clinical Oncology. 33(28):3137-43, 2015 Oct 01. |
Observational-Dx |
1,135,977 patients |
To develop and validate a competing-risk model using 2000 to 2010 SEER data for breast cancer incidence and 2010 vital statistics to adjust for the competing risk of death. |
We included 1,135,977 women age 35 to 74 years undergoing mammography with no history of breast cancer; 17% of the women had a prior breast biopsy. During a mean follow-up of 6.9 years, 17,908 women were diagnosed with invasive breast cancer. The BCSC BBD model slightly overpredicted risk (expected-to-observed ratio, 1.04; 95% CI, 1.03 to 1.06) and had modest discriminatory accuracy (area under the receiver operator characteristic curve, 0.665). Among women with proliferative findings, adding BBD to the model increased the proportion of women with an estimated 5-year risk of 3% or higher from 9.3% to 27.8% (P<.001). |
3 |
| 6. Tice JA, O'Meara ES, Weaver DL, Vachon C, Ballard-Barbash R, Kerlikowske K. Benign breast disease, mammographic breast density, and the risk of breast cancer. J Natl Cancer Inst. 105(14):1043-9, 2013 Jul 17. |
Observational-Dx |
42,818 patients |
To calculate the risk of breast cancer associated with benign breast disease and breast density. |
Benign breast disease and breast density were independently associated with breast cancer. The combination of atypical hyperplasia and very high density was uncommon (0.6% of biopsies) but was associated with the highest risk for breast cancer (HR = 5.34; 95% confidence interval [CI] = 3.52 to 8.09, P < .001). Proliferative disease without atypia (25.6% of biopsies) was associated with elevated risk that varied little across levels of density: average (HR = 1.37; 95% CI = 1.11 to 1.69, P = .003), high (HR = 2.02; 95% CI = 1.68 to 2.44, P < .001), or very high (HR = 2.05; 95% CI = 1.54 to 2.72, P < .001). Low breast density (4.5% of biopsies) was associated with low risk (HRs <1) for all benign pathology diagnoses. |
3 |
| 7. Menes TS, Rosenberg R, Balch S, Jaffer S, Kerlikowske K, Miglioretti DL. Upgrade of high-risk breast lesions detected on mammography in the Breast Cancer Surveillance Consortium. Am J Surg. 207(1):24-31, 2014 Jan. |
Observational-Dx |
957 patients |
To examine upgrade rates of high-risk breast lesions after screening mammography. |
High-risk lesions were found in 957 needle biopsies, with excision documented in 53%. Most (n = 685) were atypical ductal hyperplasia (ADH), 173 were lobular neoplasia, and 99 were papillary lesions. Upgrade to cancer varied with type of lesion (18% in ADH, 10% in lobular neoplasia, and 2% in papillary lesions). In premenopausal women with ADH, upgrade was associated with family history. Cancers associated with ADH were mostly (82%) ductal carcinoma in situ, and those associated with lobular neoplasia were mostly (56%) invasive. During a further 2 years of follow-up, cancer was documented in 1% of women with follow-up surgery and in 3% with no surgery. |
4 |
| 8. 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 |
| 9. Weinstein SP, Slanetz PJ, Lewin AA, et al. ACR Appropriateness Criteria® Supplemental Breast Cancer Screening Based on Breast Density. J Am Coll Radiol 2021;18:S456-S73. |
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 supplemental breast cancer screening based on breast density |
No results stated in abstract. |
4 |
| 10. 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 |
| 11. Maldonado S, Gandhi N, Ha T, et al. Utility of short-interval follow-up mammography after a benign-concordant stereotactic breast biopsy result. Breast. 42:50-53, 2018 Dec. |
Observational-Dx |
470 patients |
To evaluate whether a short-interval follow-up mammogram provided clinical utility after stereotactic BCBB and to examine the costs associated with this surveillance strategy. |
Of the 470 stereotactic BCBB performed, a short-interval mammogram was completed in 207 (44.0%), 9 (4.3%) of which had suspicious mammographic findings at the initial biopsy site, and 6 subsequently underwent biopsy, with none resulting in malignant or high-risk pathology. The cost of short-interval mammographic follow-up (n=207) was calculated at $28,541.16. |
4 |
| 12. Johnson JM, Johnson AK, O'Meara ES, et al. Breast cancer detection with short-interval follow-up compared with return to annual screening in patients with benign stereotactic or US-guided breast biopsy results. Radiology. 275(1):54-60, 2015 Apr. |
Observational-Dx |
17,631 biopsies |
To compare the cancer detection rate and stage after benign stereotactic or ultrasonography (US)-guided core breast biopsy between patients with short-interval follow-up (SIFU) and those who return to annual screening. |
In total, 17 631 biopsies with benign findings were identified with SIFU or RTAS imaging. In the SIFU group, 27 ipsilateral breast cancers were diagnosed in 10 715 mammographic examinations (2.5 cancers per 1000 examinations) compared with 16 cancers in 6916 mammographic examinations in the RTAS group (2.3 cancers per 1000 examinations) (P = .88). Sixteen cancers after SIFU (59%; 95% confidence interval [CI]: 39%, 78%) were invasive versus 12 after RTAS (75%; 95% CI: 48%, 93%). The invasive cancer rate was 1.5 per 1000 examinations after SIFU (95% CI: 0.9, 2.4) and 1.7 per 1000 examinations (95% CI: 0.9, 3.0) after RTAS (P = .70). Among invasive cancers, 25% were late stage (stage 2B, 3, or 4) in the SIFU group (95% CI: 7%, 52%) versus 27% in the RTAS group (95% CI: 6%, 61%). Positive lymph nodes were found in seven (44%; 95% CI: 20%, 70%) invasive cancers after SIFU and in three (25%; 95% CI: 5%, 57%) invasive cancers after RTAS. |
3 |
| 13. Schmidt H, Arditi B, Wooster M, et al. Observation versus excision of lobular neoplasia on core needle biopsy of the breast. Breast Cancer Res Treat. 168(3):649-654, 2018 Apr. |
Observational-Dx |
178 patients |
To compare observation versus excision of lobular neoplasia on core needle biopsy of the breast. |
178 cases were identified out of 62213 (0.3%). 115 (65%) patients underwent surgery, and 54 (30%) patients had surveillance for > 12 months (mean = 55 months). Of the patients who underwent surgical excision, 13/115 (11%) were malignant. Eight of these 13 found malignancy at excision when CNB results were considered discordant (5 DCIS, and 3 invasive lobular carcinoma), with the remainder, 5/115 (4%), having a true pathologic upgrade: 3 DCIS, and 2 microinvasive lobular carcinoma. Among 54 patients not having excision, 12/54 (22%) underwent subsequent CNB with only 1 carcinoma found at the initial biopsy site. |
4 |
| 14. Susnik B, Day D, Abeln E, et al. Surgical Outcomes of Lobular Neoplasia Diagnosed in Core Biopsy: Prospective Study of 316 Cases. Clin Breast Cancer. 16(6):507-513, 2016 12. |
Observational-Dx |
13,772 total percutaneous breast CB procedures |
To prospectively identify a subset of patients who do not require subsequent surgical excision (SE). |
Of 13,772 total percutaneous breast CB procedures, 302 of 370 patients diagnosed with LN underwent SE. Upgrade to carcinoma was present in 3.5% (8/228) LN-C, 26.7% LN-V (4/15), and 28.3% LN-DA (15/53). Calcifications were the imaging target for 180 (79%) of 228 LN-C cases; 7 were associated with upgrade (3.9%). Upgrades were rare for mass lesions (1/32) and magnetic resonance imaging-targeted lesions (0/14). Upgrades were similar for ALH and LCIS (3.4% vs. 4.5%). During postsurgical follow-up (mean, 34.5 months), 6.5% LN-C patients developed carcinoma in either breast. |
4 |
| 15. Chester R, Bokinni O, Ahmed I, Kasem A. UK national survey of management of breast lobular carcinoma in situ. Ann R Coll Surg Engl. 97(8):574-7, 2015 Nov. |
Observational-Tx |
N/A |
To form a picture of the current management of LCIS by UK breast surgeons. |
Of 490 questionnaires sent out, 173 (35%) were returned. When LCIS is present in a core biopsy, 61% of breast surgeons perform surgical excision, 22% would not excise but would continue follow-up and the remainder perform neither or set no clear management plan. Over half (54%) follow patients up with five years of annual mammography. If classic LCIS were found at the margins of wide local excision, 92% would not re-excise. Conversely, if pleomorphic LCIS were found, 71% would achieve clear margins. Respondents were split evenly regarding management of classic LCIS with a family history as 54% would not alter management whereas 43% would treat the disease more aggressively. |
4 |
| 16. Middleton LP, Sneige N, Coyne R, et al. Most lobular carcinoma in situ and atypical lobular hyperplasia diagnosed on core needle biopsy can be managed clinically with radiologic follow-up in a multidisciplinary setting. Cancer Med. 3(3):492-9, 2014 Jun. |
Observational-Tx |
853 patients |
To evaluate the efficacy of using standard radiologic and histologic criteria to guide the follow-up of patients with lobular carcinoma in situ (LCIS), lobular neoplasia (LN), or atypical lobular hyperplasia (ALH). |
In all, 104 patients were clinically and/or radiographically monitored. In 20 patients, who were found to have LN on core biopsy and were recommended to have immediate surgical excision, a more significant lesion was identified in 8 (40%) of the excised specimens. Factors associated with a more significant lesion on excisional biopsy included whether the lobular lesion had been targeted for biopsy and whether the extent of disease involved three or more terminal duct lobular units. Of the 104 patients radiographically and clinically monitored, the median follow-up time was 3.4 years with a range of 0.44-8.6 years. Five patients under surveillance were subsequently diagnosed with breast malignancy (three of the five at a site unrelated to the initial biopsy). Patients with incidental lobular lesions identified on percutaneous core needle biopsy have a small risk of upgrade and may not require an excisional biopsy. |
4 |
| 17. Society of Breast Imaging. Patient Resources: End The Confusion. Available at: https://www.sbi-online.org/endtheconfusion/PatientResources.aspx. |
Review/Other-Dx |
N/A |
To providc patient resources from the society of breast imaging. |
No results stated in abstract. |
4 |
| 18. Taplin SH, Abraham L, Geller BM, et al. Effect of previous benign breast biopsy on the interpretive performance of subsequent screening mammography. J Natl Cancer Inst. 102(14):1040-51, 2010 Jul 21. |
Observational-Dx |
799,613 patients |
To evaluate whether self-reported benign breast biopsy was associated with reduced subsequent screening mammography performance using examination data from the mammography registries of the Breast Cancer Surveillance Consortium from January 2, 1996, through December 31, 2005 |
A total of 2,007,381 screening mammograms were identified among 799,613 women, of which 14.6% mammograms were associated with self-reported previous breast biopsy. Multivariable adjusted models for mammography performance showed reduced specificity (odds ratio [OR] = 0.74, 95% confidence interval [CI] = 0.73 to 0.75, P < .001), PPV2 (OR = 0.85, 95% CI = 0.79 to 0.92, P < .001), and AUC (AUC 0.892 vs 0.925, P < .001) among women with self-reported benign biopsy. There was no difference in sensitivity or PPV1 in the same adjusted models, although unadjusted differences in both were found. Specificity was lowest among women with documented fine needle aspiration-the least invasive biopsy technique (OR = 0.58, 95% CI = 0.55 to 0.61, P < .001). Repeating the analysis among women with documented biopsy history, unilateral biopsy history, or restricted to invasive cancers did not change the results. |
3 |
| 19. Houssami N, Abraham LA, Onega T, et al. Accuracy of screening mammography in women with a history of lobular carcinoma in situ or atypical hyperplasia of the breast. Breast Cancer Research & Treatment. 145(3):765-73, 2014 Jun. |
Observational-Dx |
359 patients |
To investigate the accuracy and outcomes of mammography screening in women with histology-proven LCIS, ALH, ADH, or AH history who had screening through Breast Cancer Surveillance Consortium-affiliated mammography facilities. |
In the LCIS/ALH cohort [versus comparator screens] cancer incidence rates, cancer detection rates (CDR), and interval cancer rates (ICR) were significantly higher (all P < 0.001); although ICR was 4.4/1,000 screens [versus 0.9/1,000; P < 0.001] the proportion that were interval cancers did not differ between compared cohorts (P = 0.43); screening sensitivity was 76.1 % [versus 82.3 %; P = 0.43], however, specificity was significantly lower at 85.1 % [versus 90.7 %; P < 0.0001]. In the ADH/AH cohort [versus comparator] cancer rates and CDR were significantly higher (P < 0.001); although ICR was 2.6/1,000 screens [versus 0.9/1,000; P = 0.002] the proportion that were interval cancers did not differ between cohorts (P = 0.74); screening sensitivity was 81.0 % [versus 82.6 %; P = 0.74] and specificity was lower at 86.2 % [versus 90.2 %; P < 0.0001]. |
3 |
| 20. Lewin AA, Mercado CL. Atypical Ductal Hyperplasia and Lobular Neoplasia: Update and Easing of Guidelines. [Review]. AJR. American Journal of Roentgenology. 214(2):265-275, 2020 02. |
Observational-Tx |
N/A |
To synthesize the evidence regarding management of atypical hyperplasia and LCIS diagnosed on core needle biopsy and clinical implications of these diagnoses on future breast cancer risk as well as highlights areas of further research needed to improve practice guidelines for these high-risk lesions. |
No results stated in abstract. |
4 |
| 21. The American Society of Breast Surgeons. Consensus Guideline on Breast Cancer Lumpectomy Margins. Available at: https://www.breastsurgeons.org/docs/statements/Consensus-Guideline-on-Breast-Cancer-Lumpectomy-Margins.pdf. |
Review/Other-Dx |
N/A |
To provide an algorithm for re-excision surgery after lumpectomy or breast conservation for breast cancer (invasive and in-situ). |
No abstract available. |
4 |
| 22. Solin LJ.. The impact of adding radiation treatment after breast conservation surgery for ductal carcinoma in situ of the breast. [Review]. J Natl Cancer Inst Monogr. 2010(41):187-92, 2010. |
Review/Other-Tx |
N/A |
To review impact of adding radiation treatment after breast conservation surgery for ductal carcinoma in situ of the breast. |
No results stated in abstract. |
4 |
| 23. Fung F, Cornacchi SD, Reedijk M, et al. Breast cancer recurrence following radioguided seed localization and standard wire localization of nonpalpable invasive and in situ breast cancers: 5-Year follow-up from a randomized controlled trial. Am J Surg. 213(4):798-804, 2017 Apr. |
Review/Other-Dx |
298 patients |
To compare 5-year breast cancer (BC) recurrence rates in patients randomized to radioguided seed localization (RSL) or wire localization (WL) for non-palpable BC undergoing breast conserving surgery. |
Follow-up data were available for 298 patients (98%) and median follow-up time was 65 months. There were 11 (4%) cases of BC recurrence and median time to recurrence was 26 months. LR occurred in 8 patients (6 WL and 2 RSL; p = 0.28). Positive margins at first surgery (p = 0.024) and final surgery (p = 0.004) predicted for BC recurrence. |
4 |
| 24. Park G, Bae K, Hwang IY, Kim JS, Kwon WJ, Bang M. Prediction of Residual Malignancy After Excisional Biopsy for Breast Cancer With Suspicious Microcalcifications: Comparison of Mammography and Magnetic Resonance Imaging. Clin Breast Cancer 2019;19:e753-e58. |
Observational-Dx |
51 patients |
To investigate the ability of mammography and MRI to predict residual malignancy after excisional biopsy for suspicious microcalcifications and whether background parenchymal enhancement (BPE) influences the diagnostic performance of MRI. |
Thirty-two patients had residual malignancy. The average overall sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the curve for residual malignancy were 78.1%, 42.1%, 69.4%, 42.1%, 62.7%, and 0.601 for mammography and 81.2%, 57.8%, 76.4%, 57.8%, 73.5%, and 0.696 for MRI; the respective values for residual malignancy were 88.8%, 57.1%, 72.7%, 57.4%, 76.5%, and 0.73 in the low BPE group and 71.4%, 60%, 83.3%, 57.4%, 65.7%, and 0.657 in the high BPE group. |
2 |
| 25. Whaley JT, Lester-Coll NH, Morrissey SM, Milby AB, Hwang W-T, Prosnitz RG. Use of postexcision preirradiation mammography in patients with ductal carcinoma in situ of the breast treated with breast-conserving therapy. Practical Radiation Oncology. 2013;3(3):e107-e112. |
Observational-Tx |
144 patients underwent postexcision preirradiation mammography |
To investigate the value of postexcision preirradiation mammography in the management of patients with DCIS. |
Of the 144 patients who received postexcision preirradiation mammography, 34 (24%; 95% CI, 17%–31%) had residual suspicious calcifications (a “positive postexcision preirradiation mammography”). Of the 34 patients with a positive postexcision preirradiation mammography, all underwent a re-excision and 19 (56%; 95% CI, 35%–70%) were found to have residual malignancy. 10/34 patients with a positive postexcision preirradiation mammography had negative margins, of which 6 had a residual malignancy. Assuming all patients with close, positive, or indeterminate surgical margins would have undergone re-excision regardless of the findings of postexcision preirradiation mammography, postexcision preirradiation mammography resulted in a change in surgical management in 7% (10/144) of patients and removal of residual DCIS in 4% (6/144). With a median follow-up of 9.5 years, the use of postexcision preirradiation mammography was not associated with an improvement in 10-year local recurrence-free survival (94.8% vs 91.5%, P=.368). |
2 |
| 26. Oseledchyk A, Kaiser C, Nemes L, et al. Preoperative MRI in patients with locoregional recurrent breast cancer: influence on treatment modalities. Acad Radiol. 21(10):1276-85, 2014 Oct. |
Observational-Dx |
43 patients |
To evaluate the impact of preoperative magnetic resonance imaging (MRI) on management in patients with locoregional recurrent breast cancer. |
Preoperative MRI detected additional tumor foci in 15 of 43 patients (34.9%). In two cases (4.7%), the diagnosis of occult sites had no influence on the subsequent treatment. Two patients (4.7%) had an unfavorable change of surgical management with unnecessary additional resection of benign foci. Eleven patients benefited from the MRI scan detecting malignant occult lesions (25.6%) resulting in either additional surgical resection or radiotherapy. Patient and tumor characteristics in primary disease did not differ significantly between patients with a favorable impact on surgical management and patients who experienced either no benefit or even disadvantage from MRI scan. |
3 |
| 27. Teller P, Jefford VJ, Gabram SG, Newell M, Carlson GW. The utility of breast MRI in the management of breast cancer. Breast J. 16(4):394-403, 2010 Jul-Aug. |
Observational-Dx |
114 patients |
To evaluate the impact of MRI on patient management of breast cancer. |
The indications for breast MRI included: high risk screening (n = 3), diagnostic evaluation of disease after neo-adjuvant chemotherapy (n = 24) or prior to re-excision (n = 8), extent of in situ ductal, infiltrating ductal or infiltrating lobular disease histology (DCIS n = 3, IDC n = 24, ILC n = 17), identification of unknown primary (n = 2), assessment of contralateral breast (n = 4), recurrence surveillance (n = 5), and other (n = 5). MRI was concordant with clinical findings and other modalities in 70.5% of cases. MRI altered planned clinical management in 28 of 95 patients (29.5%). Management changes were favorable in 21 patients (75%). Diagnostic evaluation of the breast by MRI alters patient management in 30% of cases depending upon the indications. Alteration in patient management is favorable in 75% of cases. Evaluation of the breast by MRI alters the clinical management of nearly one-third of patients. |
4 |
| 28. Witteveen A, Otten JWM, Vliegen IMH, Siesling S, Timmer JB, IJzerman MJ. Risk-based breast cancer follow-up stratified by age. Cancer Medicine. 7(10):5291-5298, 2018 10. |
Observational-Dx |
37,230 patients |
To introduce personalized follow-up schemes by stratifying for age. |
Recurrences could be detected by mammography as well as by self-detection. For all age groups, it was optimal to have more intensive follow-up around the peak in recurrence risk in the second year after diagnosis. For the first age group (<50) with the highest risk, a slightly more intensive follow-up with one extra visit was proposed compared to the current guideline recommendation. The other age groups were recommended less visits: four for ages 50-59, three for 60-69, and three for >/=70. With this model for risk-based follow-up, clinicians can make informed decisions and focus resources on patients with higher risk, while avoiding unnecessary and potentially harmful follow-up visits for women with very low risks. |
4 |
| 29. Freedman RA, Keating NL, Partridge AH, Muss HB, Hurria A, Winer EP. Surveillance Mammography in Older Patients With Breast Cancer-Can We Ever Stop?: A Review. [Review]. JAMA Oncol. 3(3):402-409, 2017 Mar 01. |
Review/Other-Dx |
N/A |
To review the current recommendations for breast cancer screening and surveillance for older patients, the current evidence for ipsilateral and contralateral breast cancer risks in older survivors of breast cancer, and suggested approaches for discussions about surveillance mammography with older patients. |
No results stated in abstract. |
4 |
| 30. Gunia SR, Merrigan TL, Poulton TB, Mamounas EP. Evaluation of appropriate short-term mammographic surveillance in patients who undergo breast-conserving Surgery (BCS). Ann Surg Oncol. 19(10):3139-43, 2012 Oct. |
Observational-Dx |
375 patients |
To evaluate appropriate short-term mammographic surveillance in patients who undergo breast-conserving surgery. |
A total of 375 patients constituted the core group for this study. Each interval mammographic screening (6- and 18-month mammograms) resulted in additional imaging in 3-4 % of patients. There was a very low yield for identifying IBTR: 1/266 (0.4 %) for the 5-10-month postoperative mammogram and 1/286 (0.3 %) for the 16-21-month postoperative mammogram. |
3 |
| 31. Neuman HB, Schumacher JR, Francescatti AB, et al. Utility of Clinical Breast Examinations in Detecting Local-Regional Breast Events After Breast-Conservation in Women with a Personal History of High-Risk Breast Cancer. Ann Surg Oncol. 23(10):3385-91, 2016 10. |
Observational-Dx |
11,099 patients |
To examine how local-regional events are detected in a contemporary, national cohort of high-risk breast cancer survivors. |
Local-regional events were detected in 5.5 % (n = 265) of patients. Eighty-three percent were ipsilateral or contralateral in-breast events, and 17 % occurred within ipsilateral lymph nodes. Forty-eight percent of local-regional events were detected on asymptomatic breast imaging, 29 % by patients, and 10 % on clinical examination. Overall, 0.5 % of the 4854 patients had a local-regional event detected on examination. Examinations detected a higher proportion of lymph node events (8/45) compared with in-breast events (18/220). No factors were associated with method of event detection. |
4 |
| 32. Witteveen A, Vliegen IM, Sonke GS, Klaase JM, IJzerman MJ, Siesling S. Personalisation of breast cancer follow-up: a time-dependent prognostic nomogram for the estimation of annual risk of locoregional recurrence in early breast cancer patients. Breast Cancer Res Treat. 152(3):627-36, 2015 Aug. |
Review/Other-Dx |
N/A |
To develop and validate a time-dependent logistic regression model for prediction of locoregional recurrence (LRR) of breast cancer and a web-based nomogram for clinical decision support. |
No results stated in abstract. |
4 |
| 33. Kraeima J, Siesling S, Vliegen IM, Klaase JM, IJzerman MJ. Individual risk profiling for breast cancer recurrence: towards tailored follow-up schemes. Br J Cancer. 109(4):866-71, 2013 Aug 20. |
Observational-Dx |
17,762 patients |
To identify prognostic factors and to estimate individual and time-dependent LRR risk rates. |
Eight prognostic factors were identified: age, tumour size, multifocality, gradation, adjuvant chemo-, adjuvant radiation-, hormonal therapy, and triple-negative receptor status. Risk profiles of the low-, average-, and high-risk example patients showed non-uniform distribution of recurrence risks (2.9, 7.6, and 9.2%, respectively, over a 5-year period). |
4 |
| 34. Lowry KP, Braunstein LZ, Economopoulos KP, et al. Predictors of surveillance mammography outcomes in women with a personal history of breast cancer. Breast Cancer Research & Treatment. 171(1):209-215, 2018 Aug. |
Observational-Dx |
164 patients |
To identify predictors of poor mammography surveillance outcomes based on clinico-pathologic features. |
164 women met inclusion criteria (65 with IBTR, 99 with CBC); 124 had screen-detected second cancers. On univariate analysis, poor surveillance outcome (n = 40) was associated with age at primary cancer diagnosis < 50 years (p < 0.0001), AJCC stage II primary cancers (p = 0.007), and heterogeneously or extremely dense breasts (p = 0.04). On multivariate analysis, age < 50 years at primary breast cancer diagnosis remained a significant predictor of poor surveillance outcome (p = 0.001). |
3 |
| 35. Lee JM, Abraham L, Lam DL, et al. Cumulative Risk Distribution for Interval Invasive Second Breast Cancers After Negative Surveillance Mammography. J Clin Oncol. 36(20):2070-2077, 2018 07 10. |
Observational-Dx |
18,366 patients |
To characterize the risk of interval invasive second breast cancers within 5 years of primary breast cancer treatment. |
We observed 474 surveillance-detected cancers-334 invasive and 140 ductal carcinoma in situ-and 186 interval invasive cancers which yielded a cancer detection rate of 7.3 per 1,000 examinations (95% CI, 6.6 to 8.0) and an interval invasive cancer rate of 2.9 per 1,000 examinations (95% CI, 2.5 to 3.3). Median cumulative 5-year interval cancer risk was 1.4% (interquartile range, 0.8% to 2.3%; 10(th) to 90th percentile range, 0.5% to 3.7%), and 15% of women had >/= 3% 5-year interval invasive cancer risk. Cumulative 5-year interval cancer risk was highest for women with estrogen receptor- and progesterone receptor-negative primary breast cancer (2.6%; 95% CI, 1.7% to 3.5%), interval cancer presentation at primary diagnosis (2.2%; 95% CI, 1.5% to 2.9%), and breast conservation without radiation (1.8%; 95% CI, 1.1% to 2.4%). |
4 |
| 36. Lee JM, Buist DS, Houssami N, et al. Five-year risk of interval-invasive second breast cancer. J Natl Cancer Inst. 107(7), 2015 Jul. |
Observational-Dx |
15,114 patients |
To examine women presenting clinically with second breast cancers after negative surveillance mammography (interval cancers), and to estimate the five-year risk of interval-invasive second cancers for women with varying risk profiles. |
The cumulative incidence of second breast cancers after five years was 54.4 per 1000 women, with 325 surveillance-detected and 138 interval-invasive second breast cancers. The five-year risk of interval-invasive second cancer for women with referent category characteristics was 0.60%. For women with the most and least favorable profiles, the five-year risk ranged from 0.07% to 6.11%. Multivariable modeling identified grade II PBC (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.15 to 3.31), treatment with lumpectomy without radiation (OR = 3.27, 95% CI = 1.91 to 5.62), interval PBC presentation (OR = 2.01, 95% CI 1.28 to 3.16), and heterogeneously dense breasts on mammography (OR = 1.54, 95% CI = 1.01 to 2.36) as independent predictors of interval-invasive second breast cancers. |
3 |
| 37. Benveniste AP, Dryden MJ, Bedrosian I, Morrow PK, Bassett RL Jr, Yang W. Surveillance of women with a personal history of breast cancer by tumour subtype. Clin Radiol. 72(3):266.e1-266.e6, 2017 Mar. |
Observational-Dx |
207 patients |
To determine if the rate and timing of a second breast cancer event (SBCE) in women with a personal history of breast cancer varies by disease subtype or breast imaging method. |
Of 207 patients diagnosed with a SBCE, the median age at first diagnosis was 50.6 years, range 24.8 to 80.2; at second diagnosis was 56.2 years, range 25.8 to 87.9. Eleven percent of SBCE were diagnosed >10 years after the primary cancer diagnosis. The median time between the first and second diagnosis for ER-positive patients was 2.7 years (range 0.7-17.4 years); and 1.9 years for ER-negative patients, (range 0.4-23.4 years; p<0.002). Patients with triple-negative breast cancer (TNBC) had a shorter time between diagnoses than others (p=0.0003). At 3, 5, and 10 years, 85%, 92%, and 97% of ER-negative and 54%, 81%, and 95% of ER-positive tumours, respectively, had recurred. ER-negative tumours and TNBC were more likely to be visible at US. |
4 |
| 38. Houssami N, Abraham LA, Kerlikowske K, 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 May. |
Observational-Dx |
20,941 patients |
To identify risk factors for second (ipsilateral or contralateral) screen-detected or interval breast cancer within 1 year of screening in PHBC women. |
There were 697 second breast cancers, of these 240 were interval cancers, among 67,819 screens in 20,941 women. In separate models for women with DCIS or invasive first cancer, first breast cancer surgery predicted all three second breast cancer outcomes (P < 0.001), and high ORs for second breast cancers (between 1.95 and 4.82) were estimated for breast conservation without radiation (relative to mastectomy). In women with invasive first breast cancer, additional variables predicted risk (P < 0.05) for at least one of the three outcomes: first-degree family history, dense breasts, longer time between mammograms, young age at first breast cancer, first breast cancer stage, and adjuvant systemic therapy for first breast cancer; and risk of interval invasive breast cancer was highest in women <40 years at first breast cancer (OR, 3.41; 1.34-8.70), those with extremely dense breasts (OR, 2.55; 1.4-4.67), and those treated with breast conservation without radiation (OR, 2.67; 1.53-4.65). |
3 |
| 39. Houssami N, Abraham LA, Miglioretti DL, et al. Accuracy and outcomes of screening mammography in women with a personal history of early-stage breast cancer. JAMA. 305(8):790-9, 2011 Feb 23. |
Observational-Dx |
19,078 patients |
To examine the accuracy and outcomes of mammography screening in PHBC women relative to screening of similar women without PHBC. |
Mammography accuracy based on final assessment, cancer detection rate, interval cancer rate, and stage at diagnosis. RESULTS: Within 1 year after screening, 655 cancers were observed in PHBC women (499 invasive, 156 in situ) and 342 cancers (285 invasive, 57 in situ) in non-PHBC women. Screening accuracy and outcomes in PHBC relative to non-PHBC women were cancer rates of 10.5 per 1000 screens (95% CI, 9.7-11.3) vs 5.8 per 1000 screens (95% CI, 5.2-6.4), cancer detection rate of 6.8 per 1000 screens (95% CI, 6.2-7.5) vs 4.4 per 1000 screens (95% CI, 3.9-5.0), interval cancer rate of 3.6 per 1000 screens (95% CI, 3.2-4.1) vs 1.4 per 1000 screens (95% CI, 1.1-1.7), sensitivity 65.4% (95% CI, 61.5%-69.0%) vs 76.5% (95% CI, 71.7%-80.7%), specificity 98.3% (95% CI, 98.2%-98.4%) vs 99.0% (95% CI, 98.9%-99.1%), abnormal mammogram results in 2.3% (95% CI, 2.2%-2.5%) vs 1.4% (95% CI, 1.3%-1.5%) (all comparisons P < .001). Screening sensitivity in PHBC women was higher for detection of in situ cancer (78.7%; 95% CI, 71.4%-84.5%) than invasive cancer (61.1%; 95% CI, 56.6%-65.4%), P < .001; lower in the initial 5 years (60.2%; 95% CI, 54.7%-65.5%) than after 5 years from first cancer (70.8%; 95% CI, 65.4%-75.6%), P = .006; and was similar for detection of ipsilateral cancer (66.3%; 95% CI, 60.3%-71.8%) and contralateral cancer (66.1%; 95% CI, 60.9%-70.9%), P = .96. Screen-detected and interval cancers in women with and without PHBC were predominantly early stage. |
3 |
| 40. Buist DS, Bosco JL, Silliman RA, et al. Long-term surveillance mammography and mortality in older women with a history of early stage invasive breast cancer. Breast Cancer Res Treat. 142(1):153-63, 2013 Nov. |
Observational-Dx |
1,235 patients |
To examine the association between surveillance mammography beyond 5 years after diagnosis on breast cancer-specific mortality in a cohort of women aged >/= 65 years diagnosed 1990-1994 with early stage breast cancer. |
The majority (85 %) of the 1,235 5-year breast cancer survivors received >/= 1 surveillance mammogram in years 5-9 (yearly proportions ranged from 48 to 58 %); 82 % of women received >/= 1 surveillance mammogram in years 10-14. A total of 120 women died of breast cancer and 393 women died from other causes (average follow-up 7.3 years). Multivariable models and lasagna plots suggested a modest reduction in breast cancer-specific mortality with surveillance mammogram receipt in the preceding year (IRR 0.82, 95 % CI 0.56-1.19, p = 0.29); the association with other-cause mortality was 0.95 (95 % CI 0.78-1.17, p = 0.64). |
3 |
| 41. Smith-Gagen J, Carrillo JE, Ang A, Perez-Stable EJ. Practices that reduce the Latina survival disparity after breast cancer. J Womens Health (Larchmt). 22(11):938-46, 2013 Nov. |
Observational-Dx |
44,999 patients |
To study which utilization factors drive the shorter survival in Latina women compared with white women. |
Of the four utilization factors potentially driving this disparity, a lack of consistent post-diagnosis mammograms was the strongest driver of the Latina breast cancer survival disparity. Consistent mammograms attenuated the hazard of death from 23% [hazard ratio, HR, (95% confidence interval, 95%CI)=1.23 (1.1,1.4)] to a nonsignificant 12% [HR (95%CI)=1.12 (0.7,1.3)] and reduced the excess hazard of death in Latina women by 55%. Effect modification identified that visits to primary care providers have a greater protective impact on the survival of Latina compared to white women [HR (95%CI)=0.9 (0.9,0.9)]. |
3 |
| 42. American College of Radiology. ACR Practice Parameter for the Performance of Screening and Diagnostic Mammography. Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/Screen-Diag-Mammo.pdf. |
Review/Other-Dx |
N/A |
Guidance document to promote the safe and effective use of diagnostic and therapeutic radiology by describing specific training, skills and techniques. |
No abstract available. |
4 |
| 43. Patel BK, Lee CS, Kosiorek HE, Newell MS, Pizzitola VJ, D'Orsi CJ. Variability of Postsurgical Imaging Surveillance of Breast Cancer Patients: A Nationwide Survey Study. AJR. American Journal of Roentgenology. 210(1):222-227, 2018 Jan. |
Review/Other-Dx |
849 patients |
To conduct a survey to explore whether broad discrepancy exists in imaging protocols used for postsurgical surveillance. |
Seventy-nine percent of respondents recommended initial diagnostic mammography after lumpectomy (65% at 6 months, 14% at 12 months); 49% recommended diagnostic surveillance for up to 2 years before a return to screening mammography; and 33% continued diagnostic surveillance for 2-5 years before returning to screening. For imaging after mastectomy, 57% of respondents recommended diagnostic mammography of the unaffected breast. Among the 57%, however, 37% recommended diagnostic screening for only the first postmastectomy follow-up evaluation, and the other 20% permanently designated patients for diagnostic mammography after mastectomy. |
4 |
| 44. Lewin AA, Moy L, Baron P, et al. ACR Appropriateness Criteria R Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women. [Review]. Journal of the American College of Radiology. 16(11S):S428-S439, 2019 Nov. |
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 stage I breast cancer. |
No results stated in abstract. |
4 |
| 45. Adesoye T, Schumacher JR, Neuman HB, et al. Use of Breast Imaging After Treatment for Locoregional Breast Cancer (AFT-01). Ann Surg Oncol. 25(6):1502-1511, 2018 Jun. |
Observational-Dx |
9835 patients |
To study factors associated with imaging use critical to improvement of adherence to recommendations. |
Of 9835 patients, 9622, 8702, 8021, and 7457 patients were eligible for imaging at surveillance years 1 through 4 respectively. Annual receipt of breast imaging declined from year 1 (69.5%) to year 4 (61.0%), and breast MRI rates decreased from 12.5 to 5.8%. Lack of imaging was associated with age 80 years or older and age younger than 50 years, black race, public or no insurance versus private insurance, greater comorbidity, larger node-positive hormone receptor-negative tumor, excision alone or mastectomy, and no chemotherapy (p < 0.005). Receipt of breast MRI was associated with age younger than 50 years, white race, higher education, private insurance, mastectomy, chemotherapy, care at a teaching/research facility, and MRI 12 months before diagnosis (p < 0.05). |
4 |
| 46. Brawarsky P, Neville BA, Fitzmaurice GM, Hassett MJ, Haas JS. Use of annual mammography among older women with ductal carcinoma in situ. J Gen Intern Med. 27(5):500-5, 2012 May. |
Review/Other-Dx |
N/A |
To examine factors associated with receipt of an initial mammogram within 1 year of treatment and subsequent annual mammograms for 3 and 5 years. |
Overall, 91.3% of women had an initial mammogram. After adjustment, blacks and Hispanics were less likely than whites to receive an initial mammogram (odds ratio (OR) 0.74, 95% confidence interval (CI) 0.55-0.99 and OR 0.65, CI 0.46-0.93, respectively, as were women of lower socioeconomic status (SES), women who had a mastectomy or breast conserving surgery without radiation therapy, and women who did not have a physician visit. Overall rates of annual mammography decreased over time. Disparities by SES, initial treatment type, and physician visit did not diminish over time. Physician visits had a modest effect on reducing initial racial/ethnic disparities. |
4 |
| 47. Carcaise-Edinboro P, Bradley CJ, Dahman B. Surveillance mammography for Medicaid/Medicare breast cancer patients. J. cancer surviv.. 4(1):59-66, 2010 Mar. |
Review/Other-Dx |
N/A |
To assess the receipt of surveillance mammography for elderly breast cancer survivors considering their Medicaid and Medicare dual eligibility and minority status that may make them vulnerable to poor surveillance care. |
In the first year post cancer treatment, patients who received breast conserving surgery (BCS) and radiation therapy were more likely to receive surveillance mammography than those treated with BCS alone (OR = 1.82; 95% CI = 1.48-2.24). Patients who received BCS and radiation treatment also had a greater probability of receiving surveillance mammography sooner than those treated with BCS alone (HR = 1.72; 95% CI = 1.56-1.89). Time from treatment to mammography was longer for older (80+ years) versus younger patients (HR = 0.55; 95% CI = 0.45-0.66) and for those with greater comorbidity burden (HR = 0.59; 95% CI = 0.43-0.81). |
4 |
| 48. Freedman RA, Keating NL, Pace LE, Lii J, McCarthy EP, Schonberg MA. Use of Surveillance Mammography Among Older Breast Cancer Survivors by Life Expectancy. J Clin Oncol. 35(27):3123-3130, 2017 Sep 20. |
Observational-Dx |
1040 patients |
To examine surveillance mammography use among women age >/= 65 years who reported a history of breast cancer. |
Approximately 8.6% and 35.1% had an estimated life expectancy of </= 5 and </= 10 years, respectively. Overall, 78.9% reported having routine surveillance mammography in the last 12 months. Receipt of mammography decreased with decreasing life expectancy ( P < .001), although 56.7% and 65.9% of those with estimated </= 5-year and </= 10-year life expectancy, respectively, reported mammography in the last year. Conversely, 14.1% of those with life expectancy > 10 years did not report mammography. In adjusted analyses, lower ( v higher) life expectancy was significantly associated with lower odds of mammography (odds ratio, 0.4; 95% CI, 0.3 to 0.8 for </= 5-year life expectancy and OR, 0.4; 95% CI, 0.3 to 0.6 for </= 10-year life expectancy). |
3 |
| 49. Jones T, Duquette D, Underhill M, et al. Surveillance for cancer recurrence in long-term young breast cancer survivors randomly selected from a statewide cancer registry. Breast Cancer Research & Treatment. 169(1):141-152, 2018 May. |
Observational-Dx |
859 patients |
To examine clinical breast exam (CBE) and mammography surveillance in long-term young breast cancer survivors (YBCS) and identify barriers and facilitators to cancer surveillance practices. |
Among 859 YBCS (n = 340 Black; n = 519 White/Other; mean age = 51.0 +/- 5.9; diagnosed 11.0 +/- 4.0 years ago), the majority (> 85%) reported an annual CBE and a mammogram. Black YBCS in the study were more likely to report lower rates of annual mammography and more barriers accessing care compared to White/Other YBCS. Having a routine source of care, confidence to use healthcare services, perceived expectations from family members and healthcare providers to engage in cancer surveillance, and motivation to comply with these expectations were significant predictors of having annual CBEs and annual mammograms. Cost-related lack of access to care was a significant barrier to annual mammograms. |
4 |
| 50. Lopez ME, Kaplan CP, Napoles AM, et al. Ductal carcinoma in situ (DCIS): posttreatment follow-up care among Latina and non-Latina White women. J. cancer surviv.. 7(2):219-26, 2013 Jun. |
Observational-Dx |
742 patients |
To compare posttreatment care by ethnicity-language and physician specialty among Latina and White women with DCIS. |
Of 742 women (396 White, 349 Latinas), most (90 %) had at least one clinical breast exam (CBE). Among women treated with breast-conserving surgery (BCS; N = 503), 76 % had received at least two mammograms. While 92 % of all women had follow-up with a breast specialist, Spanish-speaking Latinas had the lowest specialist follow-up rates (84 %) of all groups. Lifestyle counseling was low with only 53 % discussing exercise, 43 % weight, and 31 % alcohol in relation to their DCIS. In multivariable analysis, Spanish-speaking Latinas with BCS had lower odds of receiving the recommended mammography screening in the year following treatment compared to Whites (OR 0.5; 95 % CI, 0.2-0.9). Regardless of ethnicity-language, seeing both a specialist and primary care physician increased the odds of mammography screening and CBE (OR 1.6; 95 % CI, 1.2-2.3 and OR 1.9; 95 % CI, 1.3-2.8), as well as having discussions about exercise, weight, and alcohol use, compared to seeing a specialist only. CONCLUSIONS: Most women reported appropriate surveillance after DCIS treatment. |
4 |
| 51. Choosing Wisely. American Society for Radiation Oncology. Don’t routinely recommend follow-up mammograms more often than annually for women who have had radiotherapy following breast conserving surgery. Available at: https://www.choosingwisely.org/clinician-lists/american-society-radiation-oncology-follow-up-mammograms-following-radiotherapy-for-breast-conservation/. |
Review/Other-Dx |
N/A |
To provide guidance for follow-ups mammograms. |
No results stated in abstract. |
4 |
| 52. NCCN Clinical Practice Guidelines in Oncology. Breast Cancer. NCCN Evidence Blocks. Version 3.2021. Available at: https://www.nccn.org/professionals/physician_gls/pdf/breast_blocks.pdf. |
Review/Other-Dx |
N/A |
To provide practice guidelines for breast cancer imaging. |
No results stated in abstract. |
4 |
| 53. Allen A, Cauthen A, Vaughan J, Dale P. The Clinical Utility and Cost of Postoperative Mammography Completed within One Year of Breast Conserving Therapy: Is It Worth It?. Am Surg. 83(8):871-874, 2017 Aug 01. |
Review/Other-Dx |
128 patients |
To evaluate the clinical significance and financial cost of postoperative breast imaging within one year of BCT. |
Seventy-six patients received mammograms 3 to 12 months after BCT. Six of the 76 postoperative mammograms required additional imaging/intervention for a total of seven additional imaging studies and three procedures, all of which revealed benign findings. None of these patients had physical examination findings that were of clinical concern. The total cost of postoperative imaging and procedures performed less than a year after BCT was estimated to be $32,506. Postoperative imaging performed on breast cancer patients less than a year after BCT proved to be of no medical benefit and revealed no additional significant pathology. |
4 |
| 54. Hasan S, Abel S, Simpson-Camp L, et al. Short-Term Follow-Up Mammography in Breast Conservation Therapy Likely Leads to Unnecessary Downstream Workup: A Longitudinal Study. Int J Radiat Oncol Biol Phys. 102(5):1489-1495, 2018 12 01. |
Review/Other-Dx |
569 patients |
To analyze the effect of post-radiation therapy (XRT) mammographic timing and radiation technique in relation to additional downstream workup for 569 breast conservation therapy patients treated with adjuvant XRT after their initial surveillance mammogram (MMG). |
Additional workup for those receiving an MMG within 3 months of completing XRT was 51% (73 of 143), compared with 40% (84 of 210) with MMG between 3 and 6 months and 34.5% (75 of 216) with MMG after 6 months (P=.04). Radiation boost to the postoperative bed was associated with further downstream imaging, whereas accelerated partial-breast irradiation and hypofractionated treatment were not. |
4 |
| 55. Robertson C, Arcot Ragupathy SK, Boachie C, et al. The clinical effectiveness and cost-effectiveness of different surveillance mammography regimens after the treatment for primary breast cancer: systematic reviews registry database analyses and economic evaluation. [Review]. Health Technol Assess. 15(34):v-vi, 1-322, 2011 Sep. |
Review/Other-Dx |
N/A |
To identify feasible management strategies for surveillance and follow-up of women after treatment for primary breast cancer in a UK setting, and to determine the effectiveness and cost-effectiveness of differing regimens. |
The majority of survey respondents initiate surveillance mammography 12 months after breast-conserving surgery (BCS) (87%) or mastectomy (79%). Annual surveillance mammography was most commonly reported for women after BCS or after mastectomy (72% and 53%, respectively). Most (74%) discharge women from surveillance mammography, most frequently 10 years after surgery. The majority (82%) discharge from clinical follow-up, most frequently at 5 years. Combining initiation, frequency and duration of surveillance mammography resulted in 54 differing surveillance regimens for women after BCS and 56 for women following mastectomy. The eight studies included in the clinical effectiveness systematic review suggest surveillance mammography offers a survival benefit compared with a surveillance regimen that does not include surveillance mammography. Nine studies were included in the test performance systematic review. For routine IBTR detection, surveillance mammography sensitivity ranged from 64% to 67% and specificity ranged from 85% to 97%. For magnetic resonance imaging (MRI), sensitivity ranged from 86% to 100% and specificity was 93%. For non-routine IBTR detection, sensitivity and specificity for surveillance mammography ranged from 50% to 83% and from 57% to 75%, respectively, and for MRI from 93% to 100% and from 88% to 96%, respectively. For routine MCBC detection, one study reported sensitivity of 67% and specificity of 50% for both surveillance mammography and MRI, although this was a highly select population. Data set analysis showed that IBTR has an adverse effect on survival. Furthermore, women experiencing a second tumour measuring >20 mm in diameter were at a significantly greater risk of death than those with no recurrence or those whose tumour was <10 mm in diameter. In the base-case analysis, the strategy with the highest net benefit, and most likely to be considered cost-effective, was surveillance mammography alone, provided every 12 months at a societal willingness to pay for a quality-adjusted life-year of either pound20,000 or pound30,000. The incremental cost-effectiveness ratio for surveillance mammography alone every 12 months compared with no surveillance was pound4727. |
4 |
| 56. Wallace AS, Nelson JP, Wang Z, Dale PS, Biedermann GB. In support of the Choosing Wisely campaign: Perceived higher risk leads to unnecessary imaging in accelerated partial breast irradiation?. Breast J. 24(1):12-15, 2018 01. |
Review/Other-Dx |
169 patients |
To determine clinical significance of frequent surveillance in this perceived higher risk population. |
Stage was 0, I, and II in 27%, 64%, and 9%, respectively. Most patients had pure invasive ductal cancer. Ninety-two percent and 99% of patients had imaging performed by 6 and 12 months (+/- 3 months) respectively. Median interval between end of radiation and first image, and subsequent 3 images were 6, 6, 9, and 12 months, respectively. Median follow-up was 49 months for all patients (range 7-106). Six patients experienced local recurrence: 4 invasive, all clinically detected, and none within the first 2 years. One patient had mammographically detected recurrent ductal carcinoma in situ. No mammographic images within the first year lead to diagnosis of recurrent cancer. APBI via balloon base brachytherapy offered women excellent locoregional control rates. Frequent mammographic surveillance did not result in increased detection of early recurrent disease. The result of our study are in line with the Choosing Wisely campaign recommendations to perform no more than annual follow-up for women who have completed radiation as part of BCT, with first imaging done at 6-12 months. |
4 |
| 57. Arasu VA, Joe BN, Lvoff NM, et al. Benefit of semiannual ipsilateral mammographic surveillance following breast conservation therapy. Radiology. 264(2):371-7, 2012 Aug. |
Observational-Dx |
2329 patients |
To compare cancer recurrence outcomes on the basis of compliant semiannual versus noncompliant annual ipsilateral mammographic surveillance following breast conservation therapy (BCT). |
Initially, a total of 10 750 post-BCT examinations among 2329 asymptomatic patients were identified. Excluding initial mammographic follow-up, there were 8234 examinations. Of these, 7169 examinations were semiannual with 94 recurrences detected and 1065 examinations were annual with 15 recurrences detected. There were no differences in demographic risk factors or biopsy rates. Recurrences identified at semiannual intervals were significantly less advanced than those identified at annual intervals (stage I vs stage II, P = .04; stage 0 + stage I vs stage II, P = .03). Nonsignificant findings associated with semiannual versus annual intervals included smaller tumor size (mean, 11.7 vs 15.3 mm; P = .15) and node negativity (98% vs 91%, P = .28). |
3 |
| 58. Hasan S, Gresswell S, Colosimo B, et al. Surveillance Mammography After Breast Conservation Therapy: Is Tomosynthesis Worth It?. Am J Clin Oncol. 42(8):682-686, 2019 08. |
Observational-Dx |
450 patients |
To investigate the downstream workup and costs associated with digital breast tomosynthesis (DBT) compared with 2-dimensional full field digital mammogram (FFDM) when employed as initial follow-up imaging in breast conservation therapy. |
The first posttreatment mammogram was received within 3 (20%), 3 to 6 (32%), or after 6 months (48%) following radiation. Younger patients and those undergoing hypofractionated radiation were more likely to get DBT. There were no differences in stage, receptor status, or mammogram timing between those in the FFDM and DBT groups.The following downstream workup ensued for DBT compared with FFDM imaging: 18% versus 29% short-interval (6-mo) mammogram (odds ratio=1.83, P=0.01), 6% versus 11% breast magnetic resonance imaging (odds ratio=1.90, P=0.08), 4% ultrasound for each, and 3% biopsy for each (1 positive in the FFDM group). Including downstream workup, the estimated cost per patient in the DBT group was $216.14 compared with $237.83 in the FFDM group. Independent predictors for reduced downstream workup per multivariable analysis were the use of DBT and first follow-up mammogram at least 6 months after radiation (P<0.05). |
3 |
| 59. Sia J, Moodie K, Bressel M, et al. A prospective study comparing digital breast tomosynthesis with digital mammography in surveillance after breast cancer treatment. Eur J Cancer. 61:122-7, 2016 07. |
Observational-Dx |
618 patients |
To evaluate whether the addition of DBT to digital mammography (DM) reduced the rate of indeterminate findings compared to DM alone in patients after breast cancer treatment. |
The rates of indeterminate findings for DM+DBT versus DM alone were 10.5% and 13.1%, respectively (p=0.018). In breasts treated with surgery and radiotherapy (n=558), the corresponding rates of indeterminate findings were 4.9% and 6.9%, respectively (p=0.039). The rate of indeterminate findings for DM+DBT increased with increasing breast density (p=0.019). There was no significant difference in the rates of indeterminate findings between DM and SM (13.1% versus 11.5%, p=0.1). |
3 |
| 60. Bahl M, Mercaldo S, McCarthy AM, Lehman CD. Imaging Surveillance of Breast Cancer Survivors with Digital Mammography versus Digital Breast Tomosynthesis. Radiology 2021;298:308-16. |
Observational-Dx |
8170 patients |
To determine whether DBT leads to improved screening performance metrics when compared with two-dimensional digital mammography among breast cancer survivors. |
The digital mammography and DBT groups were composed of 9019 and 22 887 mammographic examinations, respectively, in 8170 women (mean age, 62 years +/- 12 [standard deviation]). In the DBT group, the abnormal interpretation rate was lower (5.8% [1331 of 22 887 examinations] vs 6.2% [563 of 9019 examinations]; odds ratio [OR], 0.80; 95% CI: 0.71, 0.91; P = .001) and specificity was higher (95.0% [21 502 of 22 644 examinations] vs 94.7% [8424 of 8891 examinations]; OR, 1.23; 95% CI: 1.07, 1.41; P = .003) than in the digital mammography group. The cancer detection rates did not differ (8.3 per 1000 examinations with DBT vs 10.6 with digital mammography; OR, 0.76; 95% CI: 0.57, 1.02; P = .07). The proportions of screening-detected invasive cancers, versus in situ cancers, were similar (74% [140 of 189 cancers] in the DBT group vs 72% [69 of 96 cancers] in the digital mammography group; P = .69). Of 86 interval cancers, 58% (50 of 86 cancers) manifested with symptoms, and 33% (28 of 86 cancers) were detected at screening MRI. |
3 |
| 61. Yoon JH, Kim EK, Kim GR, et al. Comparing recall rates following implementation of digital breast tomosynthesis to synthetic 2D images and digital mammography on women with breast-conserving surgery. European Radiology. 30(11):6072-6079, 2020 Nov. |
Observational-Dx |
229 patients |
To evaluate the recall rates of digital mammography (DM) and synthetic images after adding digital breast tomosynthesis (DBT) in patients with breast-conserving surgery. |
Of the 229 patients included, 230 mammography images were reviewed. One patient (0.4%) developed locoregional recurrences during follow-up (mean duration, 25.8 +/- 4.5 months). Recall rates for synthetic 2D+DBT were significantly lower than for DM alone (4.1% (2.6-6.2) vs. 11.6% (9.2-14.5), respectively; p < 0.001). Recall rates did not differ between synthetic 2D+DBT and DM+DBT (4.1% (2.6-6.2) vs. 2.9% (1.9-4.5), respectively; p = 0.234). Recall rates of synthetic 2D+DBT and DM+DBT were significantly lower than those of DM alone, regardless of mammographic breast density (all p < 0.05, respectively). |
3 |
| 62. Pilewskie M, Hirsch A, Eaton A, Stempel M, Gemignani ML. Breast Cancer in the Elderly: Is MRI Helpful?. Breast J. 21(6):651-7, 2015 Nov-Dec. |
Observational-Dx |
286 patients |
To identify the indications and implications of MRI use in our elderly BC population. |
Indications for perioperative MRI include: extent of disease evaluation (181; 91%); occult primary (10; 5%); high-risk screening (5; 3%); and abnormal physical exam with negative conventional imaging (2; 1%). Disease identified by MRI only for occult primary cases was 4/10 (40%; 95% confidence interval: 12.2-73.8%) and 14/181 (7.7%; 95% confidence interval: 4.3-12.6%) for perioperative MRIs performed for extent of disease evaluation. Analysis of imaging and tumor characteristics failed to find significant predictors of disease identified by MRI only. A total of 369 post-treatment follow-up MRIs were performed in 148 patients with a median of 2 MRIs per patient (range 1-8), with seven cases of disease identified by MRI only (1.9%; 95% confidence interval: 0.8-3.9%). |
3 |
| 63. Yeom YK, Chae EY, Kim HH, Cha JH, Shin HJ, Choi WJ. Screening mammography for second breast cancers in women with history of early-stage breast cancer: factors and causes associated with non-detection. BMC Medical Imaging. 19(1):2, 2019 01 05. |
Observational-Dx |
7976 patients |
To identify the factors and causes associated with non-detection for second breast cancers on screening mammography in women with a personal history of early-stage breast cancer. |
We identified 188 patients that met the criteria. Among them, 39% of patients showed non-detection (n = 74). Of the 74 patients with non-detection, 53 (72%) were classified as having no detectable mammographic abnormality (i.e., true negative) due to overlapping dense breast tissue (n = 32), obscured by postoperative scar (n = 12) or difficult anatomic location / poor positioning (n = 9). The remaining 21 patients were categorized as having subtle findings (n = 11) or missed cancer (n = 10). Non-detection for second breast cancers were significantly associated with mammographic breast density (p = 0.001, OR = 2.959) and detectability of PBC on mammography (p = 0.011, OR = 3.013). |
3 |
| 64. Buist DSM, Abraham L, Lee CI, et al. Breast Biopsy Intensity and Findings Following Breast Cancer Screening in Women With and Without a Personal History of Breast Cancer. JAMA Internal Medicine. 178(4):458-468, 2018 04 01. |
Observational-Dx |
812164 patients |
To evaluate biopsy rates and yield in the 90 days following screening (mammography vs magnetic resonance imaging with or without mammography) among women with and without a PHBC. |
We included 101103 and 1939455 mammogram screening episodes in women with and without PHBC, respectively; MRI screening episodes included 3763 with PHBC and 4673 without PHBC. Age-adjusted core and surgical biopsy rates (per 1000 episodes) doubled (57.1; 95% CI, 50.3-65.1) following MRI compared with mammography (23.6; 95% CI, 22.4-24.8) in women with PHBC. Differences (per 1000 episodes) were even larger in women without PHBC: 84.7 (95% CI, 75.9-94.9) following MRI and 14.9 (95% CI, 14.7-15.0) following mammography episodes. Ductal carcinoma in situ and invasive biopsy yield (per 1000 episodes) was significantly higher following mammography compared with MRI episodes in women with PHBC (mammography, 404.6; 95% CI, 381.2-428.8; MRI, 267.6; 95% CI, 208.0-337.8) and nonsignificantly higher, but in the same direction, in women without PHBC (mammography, 279.3; 95% CI, 274.2-284.4; MRI, 214.6; 95% CI, 158.7-280.8). High-risk benign lesions were more commonly identified following MRI regardless of PHBC. Higher biopsy rates and lower cancer yield following MRI were not explained by increasing age or higher 5-year breast cancer risk. |
3 |
| 65. Tadros A, Arditi B, Weltz C, Port E, Margolies LR, Schmidt H. Utility of surveillance MRI in women with a personal history of breast cancer. Clin Imaging. 46:33-36, 2017 Nov - Dec. |
Observational-Dx |
812164 patients |
To evaluate biopsy rates and yield in the 90 days following screening (mammography vs magnetic resonance imaging with or without mammography) among women with and without a PHBC. |
We included 101103 and 1939455 mammogram screening episodes in women with and without PHBC, respectively; MRI screening episodes included 3763 with PHBC and 4673 without PHBC. Age-adjusted core and surgical biopsy rates (per 1000 episodes) doubled (57.1; 95% CI, 50.3-65.1) following MRI compared with mammography (23.6; 95% CI, 22.4-24.8) in women with PHBC. Differences (per 1000 episodes) were even larger in women without PHBC: 84.7 (95% CI, 75.9-94.9) following MRI and 14.9 (95% CI, 14.7-15.0) following mammography episodes. Ductal carcinoma in situ and invasive biopsy yield (per 1000 episodes) was significantly higher following mammography compared with MRI episodes in women with PHBC (mammography, 404.6; 95% CI, 381.2-428.8; MRI, 267.6; 95% CI, 208.0-337.8) and nonsignificantly higher, but in the same direction, in women without PHBC (mammography, 279.3; 95% CI, 274.2-284.4; MRI, 214.6; 95% CI, 158.7-280.8). High-risk benign lesions were more commonly identified following MRI regardless of PHBC. Higher biopsy rates and lower cancer yield following MRI were not explained by increasing age or higher 5-year breast cancer risk. |
4 |
| 66. Lee JM, Ichikawa L, Valencia E, et al. Performance Benchmarks for Screening Breast MR Imaging in Community Practice. Radiology. 285(1):44-52, 2017 10. |
Observational-Dx |
5343 patients |
To compare screening magnetic resonance (MR) imaging performance in the Breast Cancer Surveillance Consortium (BCSC) with Breast Imaging Reporting and Data System (BI-RADS) benchmarks. |
The median patient age was 52 years; 52% of MR examinations were performed in women with a first-degree family history of breast cancer, 46% in women with a personal history of breast cancer, and 15% in women with both risk factors. Screening MR imaging depicted 146 cancers, and 35 interval cancers were identified (181 total-54 in situ, 125 invasive, and two status unknown). The CDR was 17 per 1000 screening examinations (95% confidence interval [CI]: 15, 20 per 1000 screening examinations; BI-RADS benchmark, 20-30 per 1000 screening examinations). PPV2 was 19% (95% CI: 16%, 22%; benchmark, 15%). Sensitivity was 81% (95% CI: 75%, 86%; benchmark, >80%), and specificity was 83% (95% CI: 82%, 84%; benchmark, 85%-90%). The median tumor size of invasive cancers was 10 mm; 88% were node negative. |
3 |
| 67. Wernli KJ, Ichikawa L, Kerlikowske K, et al. Surveillance Breast MRI and Mammography: Comparison in Women with a Personal History of Breast Cancer. Radiology. 292(2):311-318, 2019 08. |
Review/Other-Dx |
13,266 women |
To compare performance of surveillance mammography with breast MRI. |
Breast MRI was associated with younger age at diagnosis, chemotherapy, and higher education and income. Raw performance measures for breast MRI versus mammography were as follows, respectively: cancer detection rates, 10.8 (95% confidence interval [CI]: 6.7, 14.8) versus 8.2 (95% CI: 7.3, 9.2) per 1000 examinations; sensitivity, 61.4% (27 of 44; 95% CI: 46.5%, 76.2%) versus 70.3% (279 of 397; 95% CI: 65.8%, 74.8%); and biopsy rate, 10.1% (253 of 2506; 95% CI: 8.9%, 11.3%) versus 4.0% (1343 of 33 938; 95% CI: 3.7%, 4.2%). In multivariable models, breast MRI was associated with higher biopsy rate (odds ratio [OR], 2.2; 95% CI: 1.9, 2.7; P < .001) and cancer detection rate (OR, 1.7; 95% CI: 1.1, 2.7; P = .03) than mammography alone. However, there were no differences in sensitivity (OR, 1.1; 95% CI: 0.4, 2.9; P = .84) or interval cancer rate (OR, 1.1; 95% CI: 0.6, 2.2; P = .70). |
4 |
| 68. Liu H, Hua Y, Peng W, Zhang X. Surveillance Magnetic Resonance Imaging in Detecting the Second Breast Cancer in Women With a Personal History of Breast Cancer. J Comput Assist Tomogr. 43(6):937-942, 2019 Nov/Dec. |
Observational-Dx |
798 patients |
To evaluate the diagnostic performance of magnetic resonance imaging (MRI) in detecting the secondary breast cancer among women with a personal history of the lesion. |
Of the 798 patients, 47 of the 49 secondary breast carcinomas were detected by MRI. The sensitivity and specificity of MRI in detecting the secondary lesions were 95.9% and 96.3%, respectively. The recall rate was 9.5%, and the PPV was 61.8%. Cancer detection rate of MRI examinations performed at more than 36 months after initial surgery was significantly higher than that at 36 months or less after initial surgery (13.7% vs 3.6, P < 0.001). In comparison group, the sensitivity and specificity of MRI, mammography, and ultrasound were 96.7% and 96.1%, 48.4% and 93.9%, and 77.4% and 96.1%, respectively. |
3 |
| 69. Park VY, Kim EK, Kim MJ, Moon HJ, Yoon JH. 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 01 22. |
Observational-Dx |
1044 patients |
To investigate outcomes of surveillance breast magnetic resonance (MR) imaging in women with a personal history of breast cancer. |
The CDR for MR-detected cancers was 6.7 per 1000 examinations (7 of 1053) and was 3.8 per 1000 examinations (4 of 1053) for intramammary cancers. The overall abnormal interpretation rate was 8.0%, and the abnormal interpretation rate for intramammary lesions was 7.2%. The PPV1, PPV3, sensitivity and specificity for intramammary lesions was 5.3% (4 of 76), 15.8% (3 of 19), 75.0% (3 of 4) and 98.3% (1031 of 1049), respectively. For MR examinations performed </=36 months after surgery, the overall CDR was 1.4 per 1000 examinations. For MR examinations performed > 36 months after surgery, the overall CDR was 17.4 per 1000 examinations. |
3 |
| 70. Giess CS, Poole PS, Chikarmane SA, Sippo DA, Birdwell RL. Screening Breast MRI in Patients Previously Treated for Breast Cancer: Diagnostic Yield for Cancer and Abnormal Interpretation Rate. Acad Radiol. 22(11):1331-7, 2015 Nov. |
Observational-Dx |
691 patients |
To determine the cancer detection rate and abnormal interpretation rate of screening breast magnetic resonance imaging (MRI) in previously treated breast cancer patients. |
Mean patient age at initial cancer diagnosis was 46.1 years, and mean patient age during the study interval was 52 years. Cancer detection rate was 10 per 1000 (1%; 95% confidence interval [CI], 0.5%-1.8%]; 12 of 1194 examinations). Overall 10.7% (128 of 1194) of examinations received an abnormal interpretation, including 5.4% (65 of 1194) BI-RADS 4 or 5 and 5.3% (63 of 1194) BI-RADS 3 assessments with a 9.4% positive predictive value (PPV1; 12 of 128 examinations) and a 17.9% PPV3 (12 malignancies per 67 biopsies). |
3 |
| 71. Elmore L, Margenthaler JA. Breast MRI surveillance in women with prior curative-intent therapy for breast cancer. J Surg Res. 163(1):58-62, 2010 Sep. |
Observational-Dx |
141 patients |
To determine factors that predict the use of breast magnetic resonance imaging (MRI) surveillance in women previously treated for breast cancer and the incidence of in-breast recurrences and/or new cancers identified by MRI. |
The average age of the study population was 51 (range 24-73). One hundred forty-one women underwent 202 surveillance breast MRIs during the study period. Sixteen of 141 (11%) required second look imaging, and six of 141 (4%) required biopsy of suspicious lesions. Two of the six were invasive breast cancers, while four were benign. Overall, the rate of new cancer detection on surveillance MRI during the study period was 0.9% (two of 202 imaging studies). Of the 71 women with evaluable Gail scores, the average lifetime risk score was 16.7%. Eight patients had BRCA mutations and three previously underwent irradiation for Hodgkin's lymphoma. Patient age, Gail score, tumor stage, grade, histology, receptor status, and surgical treatment were not predictive of MRI surveillance use. |
3 |
| 72. Choi SH, Choi JS, Han BK, Ko EY, Ko ES, Park KW. Long-term Surveillance of Ductal Carcinoma in Situ Detected with Screening Mammography versus US: Factors Associated with Second Breast Cancer. Radiology. 292(1):37-48, 2019 07. |
Observational-Dx |
814 patients |
To investigate whether different methods of breast cancer screening are associated with different survival outcomes in patients with screening-detected DCIS and to evaluate clinical-pathologic and imaging factors associated with second breast cancer. |
A total of 814 women (median age, 47 years; age range, 25-81 years) were included; 627 underwent treatment for screening mammography-detected DCIS (mammography-detected group), and 187 underwent treatment for screening US-detected DCIS (US-detected group). During follow-up (median, 7 years; interquartile range, 5-8 years), 26 ipsilateral and 26 contralateral second breast cancers (6.4%, 52 of 814) were found, with 44 in the mammography-detected group and eight in the US-detected group. The overall 5-year OS and DFS rates were 100% and 95.3%, respectively. DFS rates did not differ according to screening method (P = .21, 5-year DFS rates were 94.9% in the mammography-detected group and 96.5% in the US-detected group). In the mammography-detected group, higher nuclear grade (intermediate grade: hazard ratio [HR], 5.7; 95% confidence interval [CI]: 1.3, 24.3; P = 0.02) (high grade: HR, 8.0; 95% CI: 1.9, 34.2; P = .01) and dense breast (HR, 3.5; 95% CI: 1.1, 11.4; P = 0.04) were associated with second breast cancer. In the US-detected group, human epidermal growth factor receptor 2 positivity was associated with second breast cancer (HR, 9.2; 95% CI: 2.2, 38.5; P = .002). |
3 |
| 73. Song SE, Cho N, Chang JM, Chu AJ, Yi A, Moon WK. Diagnostic performances of supplemental breast ultrasound screening in women with personal history of breast cancer. Acta Radiol. 59(5):533-539, 2018 May. |
Observational-Dx |
12,230 women |
To evaluate diagnostic performances of supplemental breast US screening for women with personal history of breast cancer (PHBC) and to compare with those for women without PHBC. |
Overall cancer detection rate and first-year interval cancer rate were 1.80/1000 exams and 0.91/1000 negative exams, both of which were higher in women with PHBC than in women without PHBC (2.88 vs. 0.53 per 1000, P = 0.003; 1.50 vs. 0.20 per 1000, P = 0.027). Abnormal interpretation rate was lower in the women with PHBC than in women without PHBC (9.1% vs. 12.1%, P < 0.001). Sensitivity was not different (67.9% vs. 75.0%, P = 1.000), whereas specificity and PPV3 were higher in women with PHBC than in women without PHBC (91.2% vs. 88.0%, P < 0.001; 22.6% vs. 3.1%, P < 0.001). The majority of detected cancers in women with PHBC (78.9%, 15/19) were stage 0 or 1. |
4 |
| 74. Tsai WC, Wei HK, Hung CF, et al. Better Overall Survival for Breast Cancer Patients by Adding Breast Ultrasound to Follow-Up Examinations for Early Detection of Locoregional Recurrence-A Survival Impact Study. Ultrasound Med Biol. 42(9):2058-64, 2016 09. |
Observational-Dx |
161 patients |
To evaluate the effectiveness of our 15 y of ultrasound (US) surveillance of recurrent breast disease in comparison with mammography (MM) and clinical examination. |
The mean age of the 161 patients was 48 y (27-82 y), and the mean follow-up interval was 77.2 mo (11-167 mo). The methods of LRR detection, sites of LRR and overall survival (OS) were examined. Multivariate Cox survival analysis showed significantly better survival in groups detected by US (hazard ratio = 0.6, p = 0.042). The 10-y LRR OS by detection types for US (n = 69), clinical examination (n = 78) and MM (n = 8) were 58.5%, 33.1% and 100%, respectively (p = 0.0004). |
3 |
| 75. Park WJ, Kim EK, Moon HJ, Kim MJ, Kim SI, Park BW. Breast ultrasonography for detection of metachronous ipsilateral breast tumor recurrence. Acta Radiol. 57(10):1171-7, 2016 Oct. |
Observational-Dx |
2958 patients |
To evaluate clinical, radiologic, and pathologic findings of MIBTR retrospectively, and to assess the role of surveillance US additional to mammography for MIBTR detection. |
No significant difference was observed in the detection rate between mammography and US for overall MIBTR (84.2% vs. 85.7%; P = 0.898) or non-palpable MIBTR (88.2% vs. 81.0%; P = 0.566). US alone identified 33.3% of non-palpable MIBTRs (seven of 21). Among these cases, two had negative mammograms. All 14 MIBTRs with recent imaging surveillance were stage T2 or less, and all seven MIBTRs detected by US alone were in situ or T1; 33% of MIBTRs without recent imaging surveillance were T3 or T4. |
3 |
| 76. Wojcinski S, Farrokh A, Hille U, et al. Optimizing breast cancer follow-up: diagnostic value and costs of additional routine breast ultrasound. Ultrasound Med Biol. 37(2):198-206, 2011 Feb. |
Observational-Dx |
735 patients |
To investigate the efficacy of breast ultrasound in detecting previously occult recurrences. |
In the routine follow-up program 245 of 735 patients (33.3% [95% confidence-interval (CI): 29.9-36.7]) had an ultrasound due to abnormal local or mammographic findings. 490 of 735 patients (66.7% [95% CI: 63.3-70.1]) were initially considered asymptomatic and received an additional ultrasound exclusively within the study follow-up program. All positive examination results were followed by accelerated core needle biopsy. The routine follow-up program led to a biopsy in 66 of 735 patients (9.0%) revealing a recurrent cancer in 27 cases (3.7%). The study follow-up program with the additional ultrasound led to another 21 biopsies raising the total number of patients who had to undergo a biopsy from 9.0% (95% CI: 6.9-11.1) to 11.8% (95% CI: 9.5-14.2). Finally, we diagnosed a previously occult malignant lesion in an additional six patients following this protocol. Therefore, the rate of detected recurrences rose from 3.7% (95% CI: 2.3-5.0) in the routine follow-up program to 4.5% (95% CI: 3.0-6.0) in the study follow-up program (p = 0.041). Negative side effects were the additional costs (the costs per detected malignancy in the routine follow-up program were $2455.69; the costs for each additionally detected malignancy in the study follow-up program were $7580.30), the higher overall biopsy rate (9.0 vs. 11.8%) and the elevated benign biopsies rate (59.1% vs. 71.4%). |
3 |
| 77. Suh YJ, Kim MJ, Kim EK, Moon HJ, Kim SI, Park BW. Value of ultrasound for postoperative surveillance of asian patients with history of breast cancer surgery: a single-center study. Ann Surg Oncol. 20(11):3461-8, 2013 Oct. |
Observational-Dx |
390 patients |
To assess the diagnostic performance of postoperative ultrasound (US) surveillance for the detection of malignant lesions and to evaluate the clinical role of US in the postoperative surveillance of patients with breast cancer history. |
Among 2,925 examinations in 287 patients with mastectomy, there were 85 US-positive and 23 final-positive lesions (27 %) in 20 patients at final diagnosis. Among 1,171 examinations in 104 BCS patients, there were 32 US-positive and five final-positive (15.6 %) findings in four patients. The sensitivity, specificity, positive predictive value, and accuracy of US for final-positive lesions after breast cancer surgery were 95.8,97.8, 27.1, and 97.9 % in mastectomy patients and 42.9, 97.5, 9.4, and 97.2 % in BCS patients. Among mastectomy patients, patients with final-positive findings had a higher incidence of distant metastasis than patients without final-positive findings (31.6 vs. 9.3 %, p = 0.01). Among BCS patients, there was no distant metastasis. Among mastectomy patients, the overall survival was not significantly different between patients with only final-positive findings and in patients with final-positive findings and distant metastasis (p > 0.05). |
3 |
| 78. 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 |
