MRI was better than mammography, especially in the setting of low background parenchymal enhancement, in which sensitivity, specificity, and accuracy were 88.8%, 57.1%, and 76.5%, respectively [24]. Another small single institution study of 281 patients with ductal carcinoma in situ, of which 144 underwent postexcision preirradiation mammography, found postexcision preirradiation mammography resulted in a change in surgical management in 7% (10/144) and removal of residual ductal carcinoma in situ in 4% (6/144) of patients. More importantly there was no significant change in 10-year local recurrence-free survival (95% versus 92%, with and without postexcision preirradiation mammography) [25]. Digital Breast Tomosynthesis Screening There is no relevant literature to support the use of screening DBT in this clinical scenario. FDG-PET Breast Dedicated There is no relevant literature to support the use of FDG-PET breast in this clinical scenario. Imaging after Breast Surgery Mammography Diagnostic There is insufficient evidence to support the routine use of diagnostic mammography in this clinical scenario. However, it can be helpful in a subset of patients in which there is concern for residual microcalcifications, which are better visualized on magnification mammograms rather than DBT. One small retrospective study evaluated postexcision mammography and MRI to assess for residual disease. Of 51 patients with malignant calcifications (32 with and 19 without residual disease), mammography sensitivity, specificity, and accuracy were 78.1%, 42.1%, and 62.7%, respectively. MRI was better than mammography, especially in the setting of low background parenchymal enhancement, in which sensitivity, specificity, and accuracy were 88.8%, 57.1%, and 76.5%, respectively [24].
Imaging after Breast Surgery. MRI was better than mammography, especially in the setting of low background parenchymal enhancement, in which sensitivity, specificity, and accuracy were 88.8%, 57.1%, and 76.5%, respectively [24]. Another small single institution study of 281 patients with ductal carcinoma in situ, of which 144 underwent postexcision preirradiation mammography, found postexcision preirradiation mammography resulted in a change in surgical management in 7% (10/144) and removal of residual ductal carcinoma in situ in 4% (6/144) of patients. More importantly there was no significant change in 10-year local recurrence-free survival (95% versus 92%, with and without postexcision preirradiation mammography) [25]. Digital Breast Tomosynthesis Screening There is no relevant literature to support the use of screening DBT in this clinical scenario. FDG-PET Breast Dedicated There is no relevant literature to support the use of FDG-PET breast in this clinical scenario. Imaging after Breast Surgery Mammography Diagnostic There is insufficient evidence to support the routine use of diagnostic mammography in this clinical scenario. However, it can be helpful in a subset of patients in which there is concern for residual microcalcifications, which are better visualized on magnification mammograms rather than DBT. One small retrospective study evaluated postexcision mammography and MRI to assess for residual disease. Of 51 patients with malignant calcifications (32 with and 19 without residual disease), mammography sensitivity, specificity, and accuracy were 78.1%, 42.1%, and 62.7%, respectively. MRI was better than mammography, especially in the setting of low background parenchymal enhancement, in which sensitivity, specificity, and accuracy were 88.8%, 57.1%, and 76.5%, respectively [24].