Sestamibi MBI There is no relevant literature to support the use of Tc-99m sestamibi MBI in this clinical scenario. US Breast There is no relevant literature to support the use of breast US in this clinical scenario. Variant 5: Adult female. Surveillance following completion of breast conservation therapy for breast cancer. Negative margins. With or without radiation. Asymptomatic. Margin status is an important predictor of local recurrence of invasive or in situ cancer after breast conservation surgery. For invasive breast cancer (with or without DCIS), a negative margin is defined as no tumor on ink by histology. The aim of surveillance in patients after primary breast cancer treatment is to detect local recurrence and/or second breast cancers before symptoms develop. Women with a personal history of breast cancer develop a second breast cancer at a rate of 5% to 10% within 5 to 10 years after initial diagnosis [28-30]. Factors predicting risk of locoregional recurrence include age, tumor grade and size, multifocality, nodal involvement, receptor status, and whether the patient received radiotherapy, chemotherapy, or hormonal therapy [31-33]. Interval breast cancers have been reported in 24% to 30% with mammographic surveillance [34-36], and 7% with the use of multimodality imaging with mammography, US, and MRI [37]. Interval cancers are more likely to occur in women <40 to 50 years of age, in those with primary cancers that are negative estrogen receptor/progesterone receptor (ER/PR) or triple negative (negative ER/PR and negative HER2), in those with primary cancers being interval cancers, in patients with history of breast conservation therapy without radiation, and in women with dense breast tissue [35,36,38,39]. These patients may benefit from supplemental screening. Please refer to the ACR Imaging after Breast Surgery
Imaging after Breast Surgery. Sestamibi MBI There is no relevant literature to support the use of Tc-99m sestamibi MBI in this clinical scenario. US Breast There is no relevant literature to support the use of breast US in this clinical scenario. Variant 5: Adult female. Surveillance following completion of breast conservation therapy for breast cancer. Negative margins. With or without radiation. Asymptomatic. Margin status is an important predictor of local recurrence of invasive or in situ cancer after breast conservation surgery. For invasive breast cancer (with or without DCIS), a negative margin is defined as no tumor on ink by histology. The aim of surveillance in patients after primary breast cancer treatment is to detect local recurrence and/or second breast cancers before symptoms develop. Women with a personal history of breast cancer develop a second breast cancer at a rate of 5% to 10% within 5 to 10 years after initial diagnosis [28-30]. Factors predicting risk of locoregional recurrence include age, tumor grade and size, multifocality, nodal involvement, receptor status, and whether the patient received radiotherapy, chemotherapy, or hormonal therapy [31-33]. Interval breast cancers have been reported in 24% to 30% with mammographic surveillance [34-36], and 7% with the use of multimodality imaging with mammography, US, and MRI [37]. Interval cancers are more likely to occur in women <40 to 50 years of age, in those with primary cancers that are negative estrogen receptor/progesterone receptor (ER/PR) or triple negative (negative ER/PR and negative HER2), in those with primary cancers being interval cancers, in patients with history of breast conservation therapy without radiation, and in women with dense breast tissue [35,36,38,39]. These patients may benefit from supplemental screening. Please refer to the ACR Imaging after Breast Surgery