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Does every woman presenting with malignant calcifications require a post lumpectomy mammogram?
Hálio Rodrigues-Duarte1,2, Thiemo J A van Nijnatten1,3, Tatiana Khoury1
1Department of Radiology, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA.
Breast Cancer Research and Treatment
|April 22, 2019
Summary
Post lumpectomy mammograms (PLM) are valuable for detecting residual breast cancer after surgery, especially for tumors with microcalcifications. This imaging helps ensure clear margins and guides further treatment decisions, improving outcomes for breast conservation therapy.
Area of Science:
- Oncology
- Radiology
- Breast Surgery
Background:
- Breast-conserving surgery (BCS) with radiation therapy (XRT) offers survival rates comparable to mastectomy.
- Complete tumor removal with clear margins is crucial for successful BCS.
- Microcalcifications in breast tumors can pose challenges in ensuring complete excision.
Purpose of the Study:
- To evaluate the utility of post lumpectomy mammograms (PLM) in identifying residual malignancy.
- To assess the benefit of PLM in patients with breast cancers presenting with microcalcifications undergoing BCS.
Main Methods:
- Retrospective review of 198 patients with breast cancer and microcalcifications who underwent BCS.
- Analysis of PLM performed prior to XRT.
- Correlation of PLM findings with histopathology and surgical margins.
Main Results:
- Invasive carcinoma was found in 39.4% and DCIS alone in 60.6% of initial lumpectomies.
- Among patients with negative margins (58%), 6% had positive PLM requiring re-excision for malignancy.
- PLM demonstrated high sensitivity (88%) and specificity (95%) in detecting residual malignancy in patients with initially negative margins.
Conclusions:
- PLM is an important tool for evaluating breast conservation in patients with microcalcifications.
- Positive PLM findings in patients with negative margins indicate residual disease requiring further intervention.
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