Impact of staging computerised tomography scan in the management of loco-regional recurrence of breast cancer
Association of Breast Surgery ePoster Library. Ball J. 05/15/17; 166342; P108
Mr. James Ball
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Abstract
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AIMS: To determine the impact of staging computerised tomography (CT scan) in the management of loco regional breast cancer recurrences.
METHOD: Patients presenting to Leeds Hospitals Trust with loco-regional breast cancer recurrence between January 2010 and December 2014 were identified using electronic patient records. Those with complete clinico-pathological details and staging CT at the time of recurrence (breast, chest wall or ipsilateral axilla to primary site) were included. Cases were stratified as true positive (TP) if there was unequivocal metastases on CT report, histopathological confirmation of metastases had been obtained or increase in size on interval (3 month) scan was demonstrated, true negative (TN)= metastases free at 6 months. False positive (FP)= spontaneous resolution of abnormality on 3 month interval scan, false negative (FN)= detection of lesions on interval scans within 6 months.
RESULTS: 81 patients were included. The average time between primary diagnoses to recurrence was 4.91 years (0-42). Most cases were grade 3 cancers (n= 38) and node positive (n=65). 37-chest wall, 31 breast and 13 axillary recurrences were identified. 36/43 TN cases and 5/28 TP cases had surgery. 5 TP cases had small volume disease only. 6/7 false negative cases (8.64%) had surgery inappropriately. There was no adverse impact in the 3 false positive cases. The sensitivity, specificity, positive and negative predictive values for staging CT were 80.00%, 93.48%, 90.32% and 86.00% respectively.
CONCLUSION: This study suggests that staging CT is a valuable stratifying tool that enables appropriate management in the vast majority of loco regional recurrences.
METHOD: Patients presenting to Leeds Hospitals Trust with loco-regional breast cancer recurrence between January 2010 and December 2014 were identified using electronic patient records. Those with complete clinico-pathological details and staging CT at the time of recurrence (breast, chest wall or ipsilateral axilla to primary site) were included. Cases were stratified as true positive (TP) if there was unequivocal metastases on CT report, histopathological confirmation of metastases had been obtained or increase in size on interval (3 month) scan was demonstrated, true negative (TN)= metastases free at 6 months. False positive (FP)= spontaneous resolution of abnormality on 3 month interval scan, false negative (FN)= detection of lesions on interval scans within 6 months.
RESULTS: 81 patients were included. The average time between primary diagnoses to recurrence was 4.91 years (0-42). Most cases were grade 3 cancers (n= 38) and node positive (n=65). 37-chest wall, 31 breast and 13 axillary recurrences were identified. 36/43 TN cases and 5/28 TP cases had surgery. 5 TP cases had small volume disease only. 6/7 false negative cases (8.64%) had surgery inappropriately. There was no adverse impact in the 3 false positive cases. The sensitivity, specificity, positive and negative predictive values for staging CT were 80.00%, 93.48%, 90.32% and 86.00% respectively.
CONCLUSION: This study suggests that staging CT is a valuable stratifying tool that enables appropriate management in the vast majority of loco regional recurrences.
AIMS: To determine the impact of staging computerised tomography (CT scan) in the management of loco regional breast cancer recurrences.
METHOD: Patients presenting to Leeds Hospitals Trust with loco-regional breast cancer recurrence between January 2010 and December 2014 were identified using electronic patient records. Those with complete clinico-pathological details and staging CT at the time of recurrence (breast, chest wall or ipsilateral axilla to primary site) were included. Cases were stratified as true positive (TP) if there was unequivocal metastases on CT report, histopathological confirmation of metastases had been obtained or increase in size on interval (3 month) scan was demonstrated, true negative (TN)= metastases free at 6 months. False positive (FP)= spontaneous resolution of abnormality on 3 month interval scan, false negative (FN)= detection of lesions on interval scans within 6 months.
RESULTS: 81 patients were included. The average time between primary diagnoses to recurrence was 4.91 years (0-42). Most cases were grade 3 cancers (n= 38) and node positive (n=65). 37-chest wall, 31 breast and 13 axillary recurrences were identified. 36/43 TN cases and 5/28 TP cases had surgery. 5 TP cases had small volume disease only. 6/7 false negative cases (8.64%) had surgery inappropriately. There was no adverse impact in the 3 false positive cases. The sensitivity, specificity, positive and negative predictive values for staging CT were 80.00%, 93.48%, 90.32% and 86.00% respectively.
CONCLUSION: This study suggests that staging CT is a valuable stratifying tool that enables appropriate management in the vast majority of loco regional recurrences.
METHOD: Patients presenting to Leeds Hospitals Trust with loco-regional breast cancer recurrence between January 2010 and December 2014 were identified using electronic patient records. Those with complete clinico-pathological details and staging CT at the time of recurrence (breast, chest wall or ipsilateral axilla to primary site) were included. Cases were stratified as true positive (TP) if there was unequivocal metastases on CT report, histopathological confirmation of metastases had been obtained or increase in size on interval (3 month) scan was demonstrated, true negative (TN)= metastases free at 6 months. False positive (FP)= spontaneous resolution of abnormality on 3 month interval scan, false negative (FN)= detection of lesions on interval scans within 6 months.
RESULTS: 81 patients were included. The average time between primary diagnoses to recurrence was 4.91 years (0-42). Most cases were grade 3 cancers (n= 38) and node positive (n=65). 37-chest wall, 31 breast and 13 axillary recurrences were identified. 36/43 TN cases and 5/28 TP cases had surgery. 5 TP cases had small volume disease only. 6/7 false negative cases (8.64%) had surgery inappropriately. There was no adverse impact in the 3 false positive cases. The sensitivity, specificity, positive and negative predictive values for staging CT were 80.00%, 93.48%, 90.32% and 86.00% respectively.
CONCLUSION: This study suggests that staging CT is a valuable stratifying tool that enables appropriate management in the vast majority of loco regional recurrences.
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