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Congress: ECR24
Poster Number: C-24664
Type: EPOS Radiologist (educational)
Authorblock: A. Paluri, S. S. S. Shivalingappa, S. Sampangi; Bengaluru/IN
Disclosures:
Anusha Paluri: Nothing to disclose
Shivakumar Swamy S Shivalingappa: Nothing to disclose
Sudhakar Sampangi: Nothing to disclose
Keywords: Breast, Hybrid Imaging, Oncology, Elastography, Mammography, PET-CT, Biopsy, Molecular imaging, Cancer, Neoplasia
Learning objectives Breast conservative surgery is a common treatment for breast cancer, requiring annual imaging to monitor post-operative changes and detect early scar recurrence. Distinguishing between scar recurrence and healing scar poses a diagnostic challenge for radiologists. This case series examines the multimodality imaging findings of scar recurrence and aims to facilitate accurate differentiation from post-operative scar/changes.
Read more Background Recurrent breast cancer in imaging is given to recurrence of malignancy within the same breast at or close to the resection site more than two years following the surgical excision. Bilateral cancers diagnosed within 6 months of the first primary cancer diagnosis are categorized as synchronous cancers. Metachronous breast cancer is defined as breast cancer diagnosed after 6 months of the first primary cancer diagnosis. After breast conservation the incidence of ipsilateral recurrent breast carcinoma is about 1% per year for...
Read more Findings and procedure details Mammography with tomosynthesis findings in recurrence cases demonstrated developing asymmetry as the most common feature followed by grouped, amorphous, or pleomorphic microcalcifications with associated asymmetry and/or mass. In contrast, healing scar with fat necrosis exhibited curvilinear and larger calcifications which gradually increase in size in follow up imaging. Ultrasonography revealed ill-defined hypoechoic masses with internal vascularity and ill-defined margins in scar recurrence. In contrast, sharp margins and absence of internal vascularity are noted in post-operative scar changes. Elastography showed increased...
Read more Conclusion Recent studies have demonstrated that the onset of local recurrence is an independent predictor for survival.Mammography and ultrasound including elastography serve as the initial imaging modalities for postoperative follow-up, necessitating a comprehensive evaluation of the scar site. Comparison with prior imaging is crucial for detecting subtle changes indicative of recurrence. MRI serves as a problem-solving modality in cases where ultrasound and mammography yield inconclusive results. Early and accurate diagnosis enables timely intervention, optimizing patient outcomes.
Read more References Chen X, Liu Y, Zheng Y, et al. Imaging findings of scar recurrence after breast-conserving surgery for early-stage breast cancer. Radiol Med. 2019;124(6):501-508. doi:10.1007/s11547-018-0966-4 Chansakul T, Lai KC, Slanetz PJ. The postconservation breast: part 2, imaging findings of tumor recurrence and other long-term sequelae. American Journal of Roentgenology. 2012 Feb;198(2):331-43. Yi A, Cho N, Yang KS, Han W, Noh DY, Moon WK. Breast cancer recurrence in patients with newly diagnosed breast cancer without and with preoperative MR imaging: a matched cohort study....
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