Evaluation of local recurrences with US and MRI in breast cancer patients treated with mastectomy

The aim of this study was to evaluate the role of ultrasound and MRI compared to physical examination in the diagnosis of local chest wall recurrences. MRI of the chest wall was performed in 14 mastectomized patients with the following indications: Suspicious clinical findings: 9, suspicious findings in the routine US examination of the chest wall: 3, screening: 2. All patients were examined with US prior to MRI. Findings were compared to excisional or needle biopsy results. Biopsy results revealed local recurrences in 7 patients. The sensitivity and specificities respectively were 100% and 100% for MRI, 100% and 71% for US, 71% and 29% for clinical findings. Both US and MRI were superior compared to physical examination. We think that US of the chest wall should be a part of annual follow-ups. MRI can be performed in patients with equivocal findings. MRI, being able to demonstrate the full extent of the lesions, would also be helpful in the decision of surgery versus chemotherapy and monitoring response to therapy.