Evaluation of lesions requesting biopsy according to imaging findings in breast cancer patients who have undergone breast-conserving surgery

Abstract

Aims: In patients undergoing breast-conserving surgery (BCS), the traditional follow-up imaging methods of the breast are mammography and ultrasonography. However, after BCS and radiotherapy, it becomes more difficult with imaging methods to detect the presence of recurrence or secondary focus due to the change of normal breast structure in patients. In this study, we aimed to investigate the sensitivity, specificity and malignancy prediction values of imaging methods in the follow-up of patients who underwent BCS. Methods: 421 patients diagnosed with breast cancer who underwent BCS were retrospectively analyzed. 63 patients with histopathology results, which were categorized as BI-RADS 4 or 5 according to imaging findings in their follow-up after BCS, were included in the study. The age of diagnosis, time taken for biopsy and mammography, ultrasonography and magnetic resonance imaging findings were recorded. Patients were divided into 2 groups (benign and malignant) according to the results of biopsy. According to the pathology results, sensitivity, specificity, positive and negative predictive values and diagnostic accuracy levels of radiological imaging findings were calculated. The significance of the difference between pathology groups in terms of mean age of diagnosis and biopsy time was evaluated by Mann-Whitney U test. Categorical variables were assessed by Yates test or Fisher's exact test. Results: Of the 63 patients, 49 (77.7%) were benign and 14 (23.3%) were malignant. There was a significant difference between the two groups in mass finding on mammography and posterior acoustic shadowing on US (p=0.011, p=0.049, respectively). Conclusion: MRI is the most sensitive imaging method in post-BCS follow-up and mammography is the most specificity imaging method. The finding with the highest positive predictive value for malignancy detection is the presence of mass on mammography and posterior acoustic shadow on ultrasonography.