Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/25442
Title: Breast ultrasound in breast cancer surveillance; incremental cancers found at what cost?
Austin Authors: Bromley, Luke;Xu, Jennifer;Loh, Su-Wen;Chew, Grace ;Lau, Eddie ;Yeo, Belinda 
Affiliation: Olivia Newton-John Cancer Research Institute
The University of Melbourne, Parkville, 3010, VIC, Australia
Austin Health
Issue Date: 11-Nov-2020
metadata.dc.date: 2020-11-11
Publication information: Breast 2020; 54: 272-277
Abstract: To determine the diagnostic parameters of breast ultrasound (US) in the setting of routine radiological surveillance after a diagnosis of breast cancer and evaluate costs of the inclusion of breast US as well as any survival benefit of US detected cases of recurrence in surveillance. 622 patients underwent breast cancer surgery and follow up at Austin Health from July 2009 to December 2015. Retrospective data analysis was performed to determine; diagnostic parameters, financial costs of US and survival outcomes of US detected cases of recurrence. Patients underwent 1-9 years of breast cancer surveillance, with a median of 4.24 years. 390 (62.7%) patients underwent additional breast US surveillance to mammography. 232 (38.3%) fit criteria for use of additional breast US. 199 abnormal imaging episodes occurred, leading to 16 screen detected-cases of locoregional recurrence. US alone generated 107 abnormal images and found 9 cancers. US had a sensitivity of 44.1%, specificity of 95.2% and positive predictive value of 11.7% in comparison to mammography; 20.6%, 97.4% and 9.9% respectively. US had a biopsy rate of 4.0% and lead to an incremental cancer detection rate of 0.38%. The cost of incremental cancer found was $31,463.72 AUD. Survival outcomes based on method of detection of recurrence were insignificant (p value = 0.71). Breast US has a sensitivity of 44.1% and detected seven recurrences that were mammographically occult. Breast US has a similar PPV to mammography in surveillance. Breast US generated considerable biopsy rates and costs. Survival analysis was not able to detect any benefit of US detected cases of recurrence.
URI: https://ahro.austin.org.au/austinjspui/handle/1/25442
DOI: 10.1016/j.breast.2020.11.007
PubMed URL: 33242753
Type: Journal Article
Subjects: Biopsy rate
Breast cancer
Breast ultrasound
Diagnostic accuracy
Recurrence
Surveillance
Appears in Collections:Journal articles

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