The Usefulness of Ultrasound Surveillance for Axillary Recurrence in Women With Personal History of Breast Cancer

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the axillary recurrence rate and usefulness of axillary ultrasound (AUS) during supplementary whole-breast ultrasound (US) screening in women with a personal history of breast cancer (PHBC).
Methods: A retrospective database search identified consecutive asymptomatic women who underwent postoperative supplemental whole-breast US screening, including that of the bilateral axillae, after negative findings on mammography between January and June 2017.
Using the pathologic data or at least 1-year follow-up data as reference standards, the axillary recurrence rate, cancer detection rate (CDR), interval axillary recurrence rate per 1,000 screenings, sensitivity, specificity, and abnormal interpretation rate (AIR) were estimated.
Results: From the data of 4,430 women (mean age, 55.0 ± 10.1 years) analyzed in this study, there were five axillary recurrence cases (1.1/1,000) in the median follow-up period of 57.2 months. AUS showed a CDR of 0.2 (1/4,430; 95% confidence interval [CI], 0.01–1.3) and an interval axillary recurrence rate of 0.9 (4/4,402; 95% CI, 0.2–2.3) per 1,000 examinations.
The sensitivity and specificity were 20.0% (1/5; 95% CI, 0.5–71.6), and 99.4% (4,398/4,425; 95% CI, 99.1–99.6), respectively, while the AIR was 0.6% (28/4,430; 95% CI, 0.4–0.9%).
Conclusion: In asymptomatic women with a PHBC and negative findings on mammography, axillary recurrence after breast cancer and axillary treatment was uncommon, and the supplemental AUS screening yielded 0.2 cancers per 1,000 examinations.

참고문헌 (Reference)

• 1 Suh YJ, "Value of ultrasound for postoperative surveillance of Asian patients with history of breast cancer surgery : a single-center study" 20 : 3461-3468, 2013
• 2 Moon HJ, "US surveillance of regional lymph node recurrence after breast cancer surgery" 252 : 673-681, 2009
• 3 Wong SM, "Surgical management of the axilla in clinically node-positive patients receiving neoadjuvant chemotherapy : a national cancer database analysis" 26 : 3517-3525, 2019
• 4 Kim SY, "Supplemental breast US screening in women with a personal history of breast cancer : a matched cohort study" 295 : 54-63, 2020
• 5 Hooley RJ, "Screening US in patients with mammographically dense breasts : initial experience with Connecticut Public Act 09-41" 265 : 59-69, 2012
• 6 Pepels MJ, "Safety of avoiding routine use of axillary dissection in early stage breast cancer : a systematic review" 125 : 301-313, 2011
• 7 Howlader N, "SEER Cancer Statistics Review, 1975-2017" National Cancer Institute; 2020
• 8 Harris EE, "Prognosis after regional lymph node recurrence in patients with stage I-II breast carcinoma treated with breast conservation therapy" 98 : 2144-2151, 2003
• 9 Anderson SJ, "Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer" 27 : 2466-2473, 2009
• 10 Mamounas EP, "Predictors of locoregional recurrence after neoadjuvant chemotherapy: results from combined analysis of National Surgical Adjuvant Breast and Bowel Project B-18 and B-27" 30 : 3960-3966, 2012
• 11 Lee JM, "Performance of screening ultrasonography as an adjunct to screening mammography in women across the spectrum of breast cancer risk" 179 : 658-667, 2019
• 12 Konkin DE, "Management and outcomes of isolated axillary node recurrence in breast cancer" 141 : 867-872, 2006
• 13 Houssami N, "Early detection of second breast cancers improves prognosis in breast cancer survivors" 20 : 1505-1510, 2009
• 14 Berg WA, "Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk" 307 : 1394-1404, 2012
• 15 Kwon BR, "Detection of axillary lymph node recurrence in patients with personal history of breast cancer treated with sentinel lymph node biopsy (SLNB): results of postoperative combined ultrasound and mammography screening over five consecutive years" 60 : 852-858, 2019
• 16 Castaneda CA, "Critical review of axillary recurrence in early breast cancer" 129 : 146-152, 2018
• 17 Moon HG, "Comparable survival between pN0 breast cancer patients undergoing sentinel node biopsy and extensive axillary dissection : a report from the Korean Breast Cancer Society" 28 : 1692-1699, 2010
• 18 Berg WA, "Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer" 299 : 2151-2163, 2008
• 19 National Comprehensive Cancer Network, "Clinical practice guidelines in oncology - v.1"
• 20 Cho N, "Breast cancer screening with mammography plus ultrasonography or magnetic resonance imaging in women 50 years or younger at diagnosis and treated with breast conservation therapy" 3 : 1495-1502, 2017
• 21 Monticciolo DL, "Breast cancer screening in women at higher-than-average risk : recommendations from the ACR" 15 : 408-414, 2018
• 22 Ecanow JS, "Axillary staging of breast cancer : what the radiologist should know" 33 : 1589-1612, 2013
• 23 Chang JM, "Axillary nodal evaluation in breast cancer : state of the art" 295 : 500-515, 2020
• 24 Runowicz CD, "American Cancer Society/American Society of Clinical Oncology breast cancer survivorship care guideline" 34 : 611-635, 2016
• 25 Houssami N, "Accuracy and outcomes of screening mammography in women with a personal history of early-stage breast cancer" 305 : 790-799, 2011
• 26 Mendelson EB, "ACR BI-RADS Atlas, Breast Imaging Reporting and Data System" American College of Radiology 2013
• 27 Sickles EA, "ACR BI-RADS Atlas, Breast Imaging Reporting and Data System" American College of Radiology 2013
• 28 Moy L, "ACR Appropriateness Criteria stage I breast cancer : initial workup and surveillance for local recurrence and distant metastases in asymptomatic women" 11 : 1160-1168, 2014
• 29 Pan H, "20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years" 377 : 1836-1846, 2017