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

Authors

  • Somchanin Pipatpajong Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Sarunya Poopongpanich Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Keywords:

Breast cancer, breast conservative treatment, digital breast tomosynthesis, digital mammography, intraoperative radiation therapy

Abstract

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.

Downloads

Download data is not yet available.

References

National Cancer Institute Department of Medical Services Ministry of Public Health Thailand. Hospitalbased cancer registry 2017. Bangkok: National Cancer Institute; 2018.

Lagendijk M, van Maaren MC, Saadatmand S, Strobbe LJA, Poortmans PMP, Koppert LB, et al. Breast conserving therapy and mastectomy revisited: Breast cancer-specific survival and the influence of prognostic factors in 129,692 patients. Int J Cancer 2018;142:165-75. https://doi.org/10.1002/ijc.31034

Hartmann-Johnsen OJ, Karesen R, Schlichting E, Nygard JF. Survival is better after breast conserving therapy than mastectomy for early stage breast cancer: A registry-based follow-up study of Norwegian women primary operated between 1998 and 2008. Ann Surg Oncol 2015;22:3836-45.

https://doi.org/10.1245/s10434-015-4441-3

Agarwal S, Pappas L, Neumayer L, Kokeny K, Agarwal J. Effect of breast conservation therapy vs mastectomy on disease-specific survival for earlystage breast cancer. JAMA Surg 2014;149:267-74.

https://doi.org/10.1001/jamasurg.2013.3049

Sperk E, Astor D, Keller A, Welzel G, Gerhardt A, Tuschy B, et al. A cohort analysis to identify eligible patients for intraoperative radiotherapy (IORT) of early breast cancer. Radiat Oncol 2014;9:154.

https://doi.org/10.1186/1748-717X-9-154

Reitsamer R, Sedlmayer F, Kopp M, Kametriser G, Menzel C, Glueck S, et al. Concepts and techniques of intraoperative radiotherapy (IORT) for breast cancer. Breast Cancer 2008;15:40-6.

https://doi.org/10.1007/s12282-007-0001-4

Vaidya JS, Joseph DJ, Tobias JS, Bulsara M, Wenz F, Saunders C, et al. Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial. Lancet 2010;376:91-102.

https://doi.org/10.1016/S0140-6736(10)60837-9

Della Sala SW, Pellegrini M, Bernardi D, Franzoso F, Valentini M, Di Michele S, et al. Mammographic and ultrasonographic comparison between intraoperative radiotherapy (IORT) and conventional external radiotherapy (RT) in limited-stage breast cancer, conservatively treated. Eur J Radiol 2006;59:222-30.

https://doi.org/10.1016/j.ejrad.2006.03.003

Ruch M, Brade J, Schoeber C, Kraus-Tiefenbacher U, Schnitzer A, Engel D, et al. Long-term follow-upfindings in mammography and ultrasound after intraoperative radiotherapy (IORT) for breast cancer. Breast 2009;18:327-34. https://doi.org/10.1016/j.breast.2009.09.010

Rivera R, Smith-Bronstein V, Villegas-Mendez S, Rayhanabad J, Sheth P, Rashtian A, et al. Mammographic findings after intraoperative radiotherapy of the breast. Radiol Res Pract 2012;2012:758371. https://doi.org/10.1155/2012/758371

Lam DL, Houssami N, Lee JM. Imaging surveillance after primary breast cancer treatment. AJR Am J Roentgenol 2017;208:676-86. https://doi.org/10.2214/AJR.16.16300

Patterson SK, Roubidoux MA. Update on new technologies in digital mammography. Int J Womens Health 2014;6:781-8. https://doi.org/10.2147/IJWH.S49332

Rangarajan K, Hari S, Thulkar S, Sharma S, Srivastava A, Parshad R. Characterization of lesions in dense breasts: Does tomosynthesis help? Indian J Radiol Imaging 2016; 26:210-5.

https://doi.org/10.4103/0971-3026.184416

Houssami N, Skaane P. Overview of the evidence on digital breast tomosynthesis in breast cancer detection. Breast 2013;22:101-8. https://doi.org/10.1016/j.breast.2013.01.017

Alakhras M, Bourne R, Rickard M, Ng KH, Pietrzyk M, Brennan PC. Digital tomosynthesis: a new future for breast imaging? Clin Radiol 2013;68:e225-36. https://doi.org/10.1016/j.crad.2013.01.007

Houssami N. Digital breast tomosynthesis (3Dmammography) screening: data and implications for population screening. Expert Rev Med Devices 2015; 12:377-9.

https://doi.org/10.1586/17434440.2015.1028362

Sia J, Moodie K, Bressel M, Lau E, Gyorki D, Skandarajah A, et al. A prospective study comparing digital breast tomosynthesis with digital mammography in surveillance after breast cancer treatment. Eur J Cancer 2016;61:122-7. https://doi.org/10.1016/j.ejca.2016.04.007

Ramani SK, Rastogi A, Mahajan A, Nair N, Shet T, Thakur MH. Imaging of the treated breast post breast conservation surgery/oncoplasty: Pictorial review. World J Radiol 2017;9:321-9.

https://doi.org/10.4329/wjr.v9.i8.321

Chansakul T, Lai KC, Slanetz PJ. The postconservation breast: part 1, Expected imaging findings. AJR Am J Roentgenol 2012;198:321-30. https://doi.org/10.2214/AJR.10.7298

Downloads

Published

2023-10-17

How to Cite

1.
Pipatpajong S, Poopongpanich S. 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. Chula Med J [Internet]. 2023 Oct. 17 [cited 2024 Dec. 23];65(1). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/1072