Advantage of digital breast tomosynthesis combined with standard digital mammography over standard digital mammography alone in surveillance for local recurrent breast cancer in patients with breast conservative treatment
Keywords:
Breast cancer, breast conservative treatment, digital breast tomosynthesis, digital mammography, intraoperative radiation therapyAbstract
Background: Although breast conserving therapy (BCT) offers more advantages in addition to the competitive survival rate over the traditional treatment of mastectomy, post-BCT surveillance for cancer recurrence remains challenging.
Objectives: The purpose of this study was to compare rates of indeterminate findings of standard digital mammography (DM) plus digital breast tomosynthesis (DBT) and DM alone in patients who had undergone BCT at King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Methods: We retrospectively enrolled 150 post-BCT patients who had regular follow-up visits for cancer surveillance by radiological imaging at least for two years at the hospital from January 1, 2013 to December 31, 2014. Rates of indeterminate findings were estimated and then compared between the group of DM plus DBT and the other group of DM alone at 6-month, 12-month, 18-month and 24-month follow-up visits.
Results: The average age of the enrolled patients was 54 years, ranging from 33 to 86 years. The majority of them had not received intraoperative radiation therapy (IORT). Of those 150 patients, 31 patients (20.7%) had indeterminate findings on DM. These indeterminate findings were clarified by DBT. It was found that all asymmetrical density lesions on DM were able to be clarified by DBT (P < 0.001). On the contrary, a significant number of additional mass lesion were detected by DBT at 6-moth follow-up visits (P = 0.031).
Conclusion: The addition of DBT to DM significantly lowered rates of the indeterminate finding of asymmetrical density for surveillance in post-BCT patients.
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