Clinical Value Of Ultrasound In The Postoperative Local Regional Recurrence Of Breast Cancer

Objective To explore the clinical value of color doppler flow imaging in the postoperative local regional recurrence(LRR) of breast cancer.Methods We collected 124 suspicious recurrent cases of breast cancer who have confirmed by surgical pathology. All enrolled patients were performed palpation, ultrasound, ultrasound-guided puncture and CA15-3 test before reoperation. The results of individual and combined methods for the detection LRR of breast cancer were compared with the pathology results after reoperation. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of different methods were calculated. Receiver operating characteristic(ROC) curves were drawn to compare the diagnostic efficacy of different methods. the correlation between ultrasound and CA15-3 were analyzed by coefficient r. The χ2 test was used for count data and the t test was used for the measurement data. Meanwhile this paper has summarized the sonographic features of local regional recurrent lesions of breast cancer.Results 1. 90 patients were confirmed recurrence by pathology. The areas under ROC curve of ultrasound guided puncture, ultrasound,ultrasound combined with palpation,ultrasound combined with CA15-3,palpation and CA15-3 were 0.989, 0.845, 0.750, 0.698, 0.657 and 0.615 respectively. Ultrasound examination was significantly better than palpation in the diagnosis of regional lymph node recurrence. This sensitivity can be promted to 91.1% when combining ultrasound examination with palpation, and the differences of the sensitivity were not statistically significant in ultrasound guided puncture(97.8%) and ultrasound combined with palpation(P>0.05). 2. Ultrasound and CA15-3 have good correlation, and the correlation coefficient r=0.56. The ultrasound positive rate and accuracy have a rising trend following the rising levels of CA15-3. 3. The ultrasound features of local recurrence lesions in postoperative breast cancer were divided into regular mass type, irregular mass type and diffuse infiltrating type. The blood flow mainly of recurrent lesions was grade 1and 2. 4. The features of recurrent lymph node were as follows: similar round, local cortical thickness ≥3, vague corticomedullary structure and internal hypoechoic. The blood flow mainly of lymph nodes was peripheral type and mixed type.Conclusion 1. The diagnostic efficacy of ultrasound was good and the sensitivity was very high for early detection of LRR by palpation combined with ultrasound. The recurrent lesions can be detected earlier by ultrasound-guided puncture biopsy. 2. The positive rate and accuracy of ultrasonography were higher following the rising levels of CA15-3. There was an important clinical value for the patients to perform the ultrasound when the CA15-3 was sustained rising. 3. The LRR can be identified with the benign lesions by multiple ultrasonic parameters and unnecessary biopsy and operation can be reduce.