This study assessed the efficacy of using ultrasound (US) in the early detection of recurrence of breast cancer in patients without any symptoms.

There are two surgery options to treat patients with breast cancer; Mastectomy (removal of the entire breast) and breast conserving surgery or lumpectomy (removal of the cancer, but not the whole breast). However, there are cases in which the cancer reoccurs after surgery. Locoregional recurrence (LRR) refers to the return of the cancer at, or near, the original breast cancer site. Breast cancer, or recurrence of it, often shows no symptoms, this is referred to as being asymptomatic. The lack of symptoms often leads to a late diagnosis of the disease, which may worsen prognosis. For this reason, surveillance for early detection of recurrence is a top priority. Ultrasound imaging of the breast region, referred as locoregional ultrasonography (LRUS), is one of the methods currently used to check for LRR. It is a simple, cheap, painless test that uses sound waves to create images of the breast and surrounding tissues.

This study investigated 862 patients who underwent a mastectomy to cure breast cancer. All of these patients were asymptomatic. LRUS found lesions suspicious of LRR in 57 (6.5%) of the patients. This included either masses in the breast or suspicious regional lymph nodes. In 15 (26.3%) of these patients recurrence of the cancer was confirmed by a biopsy (microscopic examination of a tissue sample from the suspected lesion taken with a needle or by minor surgery). In the remaining 42 patients the abnormal lesions found on LRUS were not cancerous. LRUS missed 4 cases of recurrence. This was associated to a minimal false negative rate (when the test gives a negative result even though the true result is positive) of 0.5%. This study also showed that asymptomatic patients who experience a recurrence detected by LRUS have a better survival.

In summary, the study showed that LRUS was effective in the early detection of recurrence in breast cancer patients, thus improved patients’ prognosis.

LRUS is a procedure that requires a skilled and experienced technician. This study was performed at a single institute, and it is unlikely that these results could be repeated in different institutions operated by different staff.