Surveillance Outcomes by Imaging Methods in the First 5 Years After Breast Cancer Surgery

Sep 23, 2026

This retrospective cohort study compares imaging strategies during the first 5 years after breast cancer surgery. Patients treated at a single institution between January 2011 and December 2015 underwent surveillance mammography, ultrasound, or MRI-based examinations at 6- or 12-month intervals. Among 6,371 women and 28,199 mammograms, 42,759 ultrasounds, and 2,619 MRIs, 172 second breast cancer diagnoses occurred, including 19 interval cancers. Cancer detection was higher with mammography plus ultrasound than with mammography alone or ultrasound alone, with no significant difference versus MRI-based examinations. Breast density modified detection, supporting density-tailored surveillance.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Objective

Materials and Methods

Results

Conclusion

Keywords

Original Article | Breast Imaging eISSN 2005-8330 [https://doi.org/10.3348/kjr.2024.1101](https://doi.org/10.3348/kjr.2024.1101) [Korean J Radiol 2025](Korean J Radiol 2025);[26](26)([6](6))[:532-545](:532-545) Surveillance Outcomes by Imaging Methods in the First 5 Years After Breast Cancer Surgery Myoung Kyoung Kim1 *, Min Su Park2 *, Min Gyu Go2, Jeong Eon Lee3, Jong Han Yu3, Boo-Kyung Han1, Eun Young Ko1, Ji Soo Choi1, Jeongmin Lee1, Haejung Kim1, Yeon Hee Park4, Eun Sook Ko1 1 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea 2 Department of Information and Statistics, Chungnam National University, Daejeon, Republic of Korea 3 Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea 4 Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Objective: To compare the outcomes of imaging methods (mammography alone, ultrasound [US] alone, mammography combined with US, and magnetic resonance imaging [MRI]-based examination) for surveillance during the first 5 years after breast cancer surgery. Materials and Methods: This retrospective cohort study analyzed the medical records of patients who underwent breast cancer surgery at a single institution between January 2011 and December 2015. Imaging surveillance was performed at 6-month or 1-year intervals during the first 5 years. Results: A total of 6371 women (median age, 49 years; age range, 20–90 years) underwent 28199 mammograms, 42759 US, and 2619 MRI examinations. Of 172 second breast cancer diagnoses, 19 (11.0%) were interval cancers. Mammography combined with US demonstrated higher cancer detection rate (CDR) compared to mammography alone (odds ratios [OR] = 3.31, 95% confidence interval [CI]: 1.52–8.96, P = 0.009) and US alone (OR = 2.80, 95% CI: 1.71–4.65, P < 0.001), whereas there was no statistical significance when compared with MRI-based examinations (OR = 0.89, 95% CI: 0.49–1.74, P > 0.999). A statistically significant interaction was observed between the mammographic breast density (MBD) and CDR of the imaging methods (P for interaction = 0.003) . Conclusion: The CDR of surveillance mammography combined with US was comparable with that of MRI-based examinationsin an intensive surveillance setting. Considering the significant interaction between MBD and the CDR, a tailored approach for surveillance based on breast density is warranted. Keywords: Personal history of breast cancer; Surveillance; Mammography; Ultrasound; Magnetic resonance imaging INTRODUCTION Breast cancer survivors face a risk of local/regional Received: July 5, 2024 Revised: March 6, 2025 Accepted: March 7, 2025 *These authors contributed equally to this work. Corresponding author: Eun Sook Ko, MD, PhD, Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea • E-mail: [mathilda0330@gmail.com](mathilda0330@gmail.com) This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://creativecommons.org/licenses/by-nc/4.0](https://creativecommons.org/licenses/by-nc/4.0)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. recurrence or new primary cancer in the contralateral breast. Recurrences and second breast cancers (SBC) are associated with an increased incidence of distant metastases and breast cancer mortality [1] . Post-treatment imaging surveillance aims to detect early recurrence of breast cancer, enabling early interventions that improve survival and preserve the quality of life [2]. To achieve this goal, most guidelines [3-5] recommend annual mammography in women with a

FAQs

What imaging methods were compared for breast cancer surveillance in the first 5 years after surgery?

The study compared mammography alone, ultrasound alone, mammography combined with ultrasound, and MRI-based examinations.

How was surveillance imaging scheduled during the study period?

Imaging surveillance was performed at 6-month or 1-year intervals during the first 5 years.

Which imaging combination showed the highest cancer detection rate?

Mammography combined with ultrasound demonstrated a higher cancer detection rate than mammography alone and ultrasound alone.

How does mammographic breast density influence surveillance outcomes?

A significant interaction was found between mammographic breast density and cancer detection rate, supporting a tailored surveillance approach based on breast density.

Sep 23, 2026

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