Follow-up after breast-conserving therapy: Comparison of conventional imaging methods with MRI

Purpose: Breast-conserving therapy is now the standard procedure for the su rgical treatment of breast cancer. With the risk of local recurrence being 1-2% or more per year after treatment, follow-up including clinical examina tion, mammography and even sonography is important. Material and Methods: We studied the efficacy of contrast-enhanced dynamic magnetic resonance tomography (MRI) for the diagnosis of local recurrences after breast-conserving therapy compared with palpation, mammography and ul trasound. Results: In 71 patients local recurrence was diagnosed after breast-conserv ing therapy. The sensitivity for the diagnosis of local recurrence was 52% for palpation, 66% for mammography, 86% for ultrasound and 92% for MRI. All multicentric local recurrences were diagnosed by MRI. Mammography was not able to detect 24 of 71 local recurrences in radiodense breasts. Ultrasound detected 18 of these 24 recurrences and MRI detected 22. Conclusion: Ultrasound should be included into routine followup protocols a fter breast-conserving therapy to achieve an acceptable sensitivity for the detection of local recurrences. Under defined conditions and indications M RI is the best method to complement clinical examination, mammography and u ltrasound with the highest sensitivity for the diagnosis of local recurrenc es in the radiodense breast.