Local tumor recurrence following breast-conservation therapy: Correlation of histopathologic findings with detection method and mammographic findings

PURPOSE: To correlate histopathologic findings with detection method and ma mmographic appearance in primary and locally recurrent breast carcinoma aft er breast-conservation therapy. MATERIALS AND METHODS: Medical records and mammographic findings were retro spectively reviewed; 26 patients with 27 local recurrences after breast-con servation therapy were identified. RESULTS: Primary histopathologic findings included six in situ and 20 invas ive carcinomas. Of the 27 recurrences, 19 (70%) were at or adjacent to the lumpectomy site and eight (30%) were elsewhere in the breast. All primary d uctal carcinoma in situ (DCIS) cases manifested mammographically as microca lcifications and recurred as DCIS with microcalcifications. Eleven primary invasive carcinomas (10 masses, ne case of microcalcifications) were detect ed only mammographically, three were detected only with physical examinatio n, and six (six masses) were detected with both. Among these 20 recurrences , 14 (five masses, nine cases of microcalcifications) were detected only ma mmographically, one was detected only with physical examination, and five ( five masses) were detected with both. Seventeen (85%) of 20 primary invasiv e carcinomas recurred invasively: 16 (94%) with similar histopathologic fin dings and eight (47%) with similar mammographic findings. CONCLUSION: In local recurrence after breast-conservation therapy for DCIS, histopathologic findings, detection method, and mammographic findings are usually similar. Histopathologic finding of primary invasive breast carcino ma and local recurrence are usually similar, but the detection method and m ammographic findings vary. This is relevant to the interpretation of new cl inical or mammographic findings following lumpectomy.