[The echographic picture of the breast following quadrantectomy and radiation therapy]

Our experience moved from the clinical relevance of an eventual positive role of US in the follow-up of breast cancers treated with conservative therapy. This trial was suggested by the more and more frequent use of conservative therapy an by the diagnostic difficulties offered by the breasts treated with surgery and radiation therapy. Aim of the study is to analyze the diagnostic value of US in the identification of local relapse in a group of 60 patients with breast carcinoma (stages I and II) treated with conservative therapy. The patients were studied for at least 2 years following treatment, with clinical, US, and mammographic controls at 6, 12, and 24 months. The following clinical problems were considered: 1) study of the US patterns of the morphological and structural changes induced by conservative treatment; 2) observation of US and mammographic agreement in case of local relapse; 3) role of US in the follow-up of this kind of patients. US patterns and results at 6 months follow: cutaneous scar (60/60 cases), skin thickening (55/60), architectural distortion (asymmetry and amputation of the glandular cone, intramammary scar) (52/60), volumetric changes in the treated breast (50/60), skin asymmetry and retraction (50/60), "parenchymal fibrosis" (48/60), mass (8/60) and calcifications (3/60). As for the very few relapses (4 cases), US failed to reveal a ductal carcinoma which presented as microcalcifications. In our experience, US is a complementary exam to clinical and radiologic investigations, especially in the period immediately following therapy and in case of particular clinical problems, such as increased breast volume, mastitis, and appearance of a nodule.