In a small study evaluating MRI in women with a unilateral mastectomy, the cancer detection rate was 10 per 1,000 in the asymptomatic mastectomy side, and these cancers would have otherwise been undetected until symptomatic because screening mammography is not performed after mastectomy. In this population, surveillance MR had a sensitivity of 66.7%, a specificity of 99.2%, a PPV of 57.1%, and an NPV of 99.5%. Larger studies are needed to assess the utility of surveillance MR in the setting of mastectomy [201]. MRI Breast Without IV Contrast There is no evidence to support the use of noncontrast breast MRI in surveillance. US Breast There is limited evidence to support the use of US breast for surveillance in the women with history of mastectomy. Variant 8: Suspected local recurrence of breast cancer based on symptoms, physical examination, or laboratory value in patient with history of BCT. Regardless of clinical stage at time of original presentation. Digital Breast Tomosynthesis Diagnostic Mammography can assist in monitoring women with a history of breast cancer and evaluating for suspicion of local recurrence. Diagnostic DBT improves lesion characterization in noncalcified lesions when compared with conventional mammographic workup [202]. The performance of DM versus DBT has not been determined for symptomatic imaging specifically in the post-BCT population. FDG-PET/CT Skull Base to Mid-Thigh There is no evidence to support the use of FDG-PET/CT to evaluate for locoregional recurrence after BCT. Mammography Diagnostic Mammography can assist in monitoring women with a history of breast cancer and evaluating for suspicion of local recurrence. Diagnostic DBT improves lesion characterization in noncalcified lesions when compared with conventional mammographic workup [202]. The performance of DM versus DBT has not been determined for symptomatic imaging specifically in the post-BCT population.
Imaging of Invasive Breast Cancer. In a small study evaluating MRI in women with a unilateral mastectomy, the cancer detection rate was 10 per 1,000 in the asymptomatic mastectomy side, and these cancers would have otherwise been undetected until symptomatic because screening mammography is not performed after mastectomy. In this population, surveillance MR had a sensitivity of 66.7%, a specificity of 99.2%, a PPV of 57.1%, and an NPV of 99.5%. Larger studies are needed to assess the utility of surveillance MR in the setting of mastectomy [201]. MRI Breast Without IV Contrast There is no evidence to support the use of noncontrast breast MRI in surveillance. US Breast There is limited evidence to support the use of US breast for surveillance in the women with history of mastectomy. Variant 8: Suspected local recurrence of breast cancer based on symptoms, physical examination, or laboratory value in patient with history of BCT. Regardless of clinical stage at time of original presentation. Digital Breast Tomosynthesis Diagnostic Mammography can assist in monitoring women with a history of breast cancer and evaluating for suspicion of local recurrence. Diagnostic DBT improves lesion characterization in noncalcified lesions when compared with conventional mammographic workup [202]. The performance of DM versus DBT has not been determined for symptomatic imaging specifically in the post-BCT population. FDG-PET/CT Skull Base to Mid-Thigh There is no evidence to support the use of FDG-PET/CT to evaluate for locoregional recurrence after BCT. Mammography Diagnostic Mammography can assist in monitoring women with a history of breast cancer and evaluating for suspicion of local recurrence. Diagnostic DBT improves lesion characterization in noncalcified lesions when compared with conventional mammographic workup [202]. The performance of DM versus DBT has not been determined for symptomatic imaging specifically in the post-BCT population.