[Concealed local recurrence after breast-conserving treatment]

Three women, aged 43, 50 and 49 years, presented themselves with subjective changes of the breast 8, 17 and 16 years respectively after breast conserving surgery. Mammography and ultrasonography revealed no indications for a local recurrence, but in the first patient Technetium-99m-sestamibi (MIBI) scintimammography did. All three patients underwent mammary ablation, radiotherapy and hyperthermia. The first one died from metastatic disease. The traditional way to diagnose breast abnormalities is inspection, palpation, mammography combined with ultrasonography and MRI. When local breast cancer recurrence is suspected following breast-conserving treatment, these investigations are often inconclusive. Mammography and ultrasonography in particular give many false-negative results. It is therefore important to send these patients to an experienced physician and not to be too reserved in performing a blind biopsy. Performing an MIBI scintimammography can be helpful in differentiating between malignant and benign lesions of the breast.