MAMMOGRAPHIC FEATURES AFTER CONSERVATION THERAPY FOR MALIGNANT BREASTDISEASE - SERIAL FINDINGS STANDARDIZED BY REGRESSION-ANALYSIS

OBJECTIVE. The purpose of this study was to determine the incidence an d natural history of mammographic changes in patients within 5 years o f conservation therapy for malignant breast disease. MATERIALS AND MET HODS. We reviewed the records of 164 consecutive patients with a histo ry of conservation therapy for malignant disease. We recorded mammogra phic changes related to treatment for each year after surgery. Linear regression analysis was applied to determine trends for progression, r egression, or stability of findings. RESULTS. We evaluated 158 patient s with 162 lesions for which initial mammographic evaluation had occur red within 5 years of surgery. Of these 158 patients, 121 (77%) underw ent serial studies. A total of 152 patients (96%) showed changes on ma mmograms that represented scarring, usually in multiple locations. Fin dings at initial evaluation included architectural distortion (n = 110 ; 82%), increased regional density or scarring (n = 106; 79%), skin th ickening (n = 73; 54%), masses (n = 16; 12%), and calcifications (n = 4; 3%). All findings except calcifications showed partial resolution o ver time, with architectural distortion showing the most significant r esolution (p =.05). CONCLUSION. Mammographic features after conservati on therapy for breast cancer are common at I year after treatment. Wit h the exception of calcifications, we found that all changes showed de creased prominence during the next 5 years. Recognition of such trends during routine surveillance should facilitate the early identificatio n of changes that represent recurrence or de novo malignancy.