Surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer

a systematic review

Clare Robertson, Senthil Kumar Arcot Ragupathy, Charles Boachie, Cynthia Fraser, Steve D Heys, Graeme Maclennan, Graham Mowatt, Ruth E Thomas, Fiona J Gilbert, Mammographic Surveillance Health Technology Assessment Group

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: To determine the diagnostic accuracy of surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer.

METHODS: A systematic review of surveillance mammography compared with ultrasound, magnetic resonance imaging (MRI), specialist-led clinical examination or unstructured primary care follow-up, using histopathological assessment for test positives and follow-up for test negatives as the reference standard.

RESULTS: Nine studies met our inclusion criteria. Variations in study comparisons precluded meta-analysis. For routine ipsilateral breast tumour detection, surveillance mammography sensitivity ranged from 64-67% and specificity ranged from 85-97%. For MRI, sensitivity ranged from 86-100% and specificity was 93%. For non-routine ipsilateral breast tumour detection, sensitivity and specificity for surveillance mammography ranged from 50-83% and 57-75% and for MRI 93-100% and 88-96%. For routine metachronous contralateral breast cancer detection, one study reported sensitivity of 67% and specificity of 50% for both surveillance mammography and MRI.

CONCLUSION: Although mammography is associated with high sensitivity and specificity, MRI is the most accurate test for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. Results should be interpreted with caution because of the limited evidence base. Key Points • Surveillance mammography is associated with high sensitivity and specificity • Findings suggest that MRI is the most accurate test for detecting further breast cancer • Robust conclusions cannot be made due to the limited evidence base • Further research comparing surveillance mammography and other diagnostic tests is required.

Original languageEnglish
Pages (from-to)2484-2491
Number of pages8
JournalEuropean Radiology
Volume21
Issue number12
Early online date11 Aug 2011
DOIs
Publication statusPublished - Dec 2011

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Mammography
Breast Neoplasms
Recurrence
Magnetic Resonance Imaging
Sensitivity and Specificity
Routine Diagnostic Tests
Meta-Analysis
Primary Health Care

Cite this

Robertson, C., Ragupathy, S. K. A., Boachie, C., Fraser, C., Heys, S. D., Maclennan, G., ... Mammographic Surveillance Health Technology Assessment Group (2011). Surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer: a systematic review. European Radiology, 21(12), 2484-2491. https://doi.org/10.1007/s00330-011-2226-z

Surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer : a systematic review. / Robertson, Clare; Ragupathy, Senthil Kumar Arcot; Boachie, Charles; Fraser, Cynthia; Heys, Steve D; Maclennan, Graeme; Mowatt, Graham; Thomas, Ruth E; Gilbert, Fiona J; Mammographic Surveillance Health Technology Assessment Group.

In: European Radiology, Vol. 21, No. 12, 12.2011, p. 2484-2491.

Research output: Contribution to journalArticle

Robertson, C, Ragupathy, SKA, Boachie, C, Fraser, C, Heys, SD, Maclennan, G, Mowatt, G, Thomas, RE, Gilbert, FJ & Mammographic Surveillance Health Technology Assessment Group 2011, 'Surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer: a systematic review', European Radiology, vol. 21, no. 12, pp. 2484-2491. https://doi.org/10.1007/s00330-011-2226-z
Robertson, Clare ; Ragupathy, Senthil Kumar Arcot ; Boachie, Charles ; Fraser, Cynthia ; Heys, Steve D ; Maclennan, Graeme ; Mowatt, Graham ; Thomas, Ruth E ; Gilbert, Fiona J ; Mammographic Surveillance Health Technology Assessment Group. / Surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer : a systematic review. In: European Radiology. 2011 ; Vol. 21, No. 12. pp. 2484-2491.
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abstract = "OBJECTIVES: To determine the diagnostic accuracy of surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. METHODS: A systematic review of surveillance mammography compared with ultrasound, magnetic resonance imaging (MRI), specialist-led clinical examination or unstructured primary care follow-up, using histopathological assessment for test positives and follow-up for test negatives as the reference standard. RESULTS: Nine studies met our inclusion criteria. Variations in study comparisons precluded meta-analysis. For routine ipsilateral breast tumour detection, surveillance mammography sensitivity ranged from 64-67{\%} and specificity ranged from 85-97{\%}. For MRI, sensitivity ranged from 86-100{\%} and specificity was 93{\%}. For non-routine ipsilateral breast tumour detection, sensitivity and specificity for surveillance mammography ranged from 50-83{\%} and 57-75{\%} and for MRI 93-100{\%} and 88-96{\%}. For routine metachronous contralateral breast cancer detection, one study reported sensitivity of 67{\%} and specificity of 50{\%} for both surveillance mammography and MRI. CONCLUSION: Although mammography is associated with high sensitivity and specificity, MRI is the most accurate test for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. Results should be interpreted with caution because of the limited evidence base. Key Points • Surveillance mammography is associated with high sensitivity and specificity • Findings suggest that MRI is the most accurate test for detecting further breast cancer • Robust conclusions cannot be made due to the limited evidence base • Further research comparing surveillance mammography and other diagnostic tests is required.",
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AU - Heys, Steve D

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N2 - OBJECTIVES: To determine the diagnostic accuracy of surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. METHODS: A systematic review of surveillance mammography compared with ultrasound, magnetic resonance imaging (MRI), specialist-led clinical examination or unstructured primary care follow-up, using histopathological assessment for test positives and follow-up for test negatives as the reference standard. RESULTS: Nine studies met our inclusion criteria. Variations in study comparisons precluded meta-analysis. For routine ipsilateral breast tumour detection, surveillance mammography sensitivity ranged from 64-67% and specificity ranged from 85-97%. For MRI, sensitivity ranged from 86-100% and specificity was 93%. For non-routine ipsilateral breast tumour detection, sensitivity and specificity for surveillance mammography ranged from 50-83% and 57-75% and for MRI 93-100% and 88-96%. For routine metachronous contralateral breast cancer detection, one study reported sensitivity of 67% and specificity of 50% for both surveillance mammography and MRI. CONCLUSION: Although mammography is associated with high sensitivity and specificity, MRI is the most accurate test for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. Results should be interpreted with caution because of the limited evidence base. Key Points • Surveillance mammography is associated with high sensitivity and specificity • Findings suggest that MRI is the most accurate test for detecting further breast cancer • Robust conclusions cannot be made due to the limited evidence base • Further research comparing surveillance mammography and other diagnostic tests is required.

AB - OBJECTIVES: To determine the diagnostic accuracy of surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. METHODS: A systematic review of surveillance mammography compared with ultrasound, magnetic resonance imaging (MRI), specialist-led clinical examination or unstructured primary care follow-up, using histopathological assessment for test positives and follow-up for test negatives as the reference standard. RESULTS: Nine studies met our inclusion criteria. Variations in study comparisons precluded meta-analysis. For routine ipsilateral breast tumour detection, surveillance mammography sensitivity ranged from 64-67% and specificity ranged from 85-97%. For MRI, sensitivity ranged from 86-100% and specificity was 93%. For non-routine ipsilateral breast tumour detection, sensitivity and specificity for surveillance mammography ranged from 50-83% and 57-75% and for MRI 93-100% and 88-96%. For routine metachronous contralateral breast cancer detection, one study reported sensitivity of 67% and specificity of 50% for both surveillance mammography and MRI. CONCLUSION: Although mammography is associated with high sensitivity and specificity, MRI is the most accurate test for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. Results should be interpreted with caution because of the limited evidence base. Key Points • Surveillance mammography is associated with high sensitivity and specificity • Findings suggest that MRI is the most accurate test for detecting further breast cancer • Robust conclusions cannot be made due to the limited evidence base • Further research comparing surveillance mammography and other diagnostic tests is required.

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