Comparison of Clinical Breast Exam to Breast MRI Surveillance in Patients Following Nipple-Sparing Mastectomy.

Autor: Weed C; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Wang T; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Mohan SC; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Wang X; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Tseng J; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Hu T; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Jaswinder J; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Boyle MK; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Amersi F; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Giuliano A; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Chung A; Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA. Electronic address: alice.chung@cshs.org.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2024 Jul; Vol. 24 (5), pp. 457-462. Date of Electronic Publication: 2024 Mar 20.
DOI: 10.1016/j.clbc.2024.03.011
Abstrakt: Background: Nipple sparing mastectomy (NSM) is increasingly being performed for patients with breast cancer. However, optimal postoperative surveillance has not been defined.
Methods: A prospectively maintained database identified patients with in-situ and invasive cancer who underwent NSM between 2007-2021. Clinical data on postoperative breast surveillance and interventions were collected. Patients who had MRI surveillance versus clinical breast exam (CBE) alone were compared with respect to tumor characteristics, recurrence, and survival.
Results: A total of 483 NSMs were performed on 399 patients. 255 (63.9%) patients had invasive ductal carcinoma, 31 (7.8%) invasive lobular carcinoma, 92 (23.1%) DCIS, 6 (1.5%) mixed ductal and lobular carcinoma, 9 (2.3%) others, and 6 (1.5%) unknown. Postoperatively, 265 (66.4%) patients were followed with CBE alone and 134 (33.6%) had surveillance MRIs. At a median follow-up of 33 months, 20 patients (5.0%) developed in-breast recurrence, 6 patients had (1.5%) an axillary recurrence, and 28 with (7.0%) distant recurrence. 14 (53.8%) LRR were detected in the CBE group and 12 (46.2%) were detected in the MRI group (P = .16). Overall survival (OS) was 99%, with no difference in OS between patients who had CBE alone versus MRI (P = .46). MRI was associated with higher biopsy rates compared to CBE alone (15.8% vs. 7.8%, P = .01).
Conclusions: Compared to CBE alone, the use of screening MRI following NSM results in higher rate of biopsy and no difference in overall survival.
Competing Interests: Disclosure The authors have no conflicts of interest to report.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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