Post-operative imaging surveillance of patients with breast cancer

Karcinom dojke je najčešća zloćudna bolest u svijetu i prvi uzrok smrtnosti od karcinoma u ţena. U Hrvatskoj karcinom dojke čini najčešće sijelo karcinoma u ţena i treći je uzrok smrti od karcinoma. Incidencija karcinoma dojke je u porastu zbog sve više prisutnih okolišnih faktora rizika. Zbog napretka u ranoj dijagnostici i liječenju karcinoma, mortalitet je u padu i raste potreba za adekvatnim načinom praćenja. Cilj redovitog praćenja je rano otkrivanje lokalnog povrata bolesti, novog primarnog tumora i metastatske bolesti što omogućuje liječenje u ranom stadiju bolesti veće preţivljenje. Redovita kontrola je potrebna u svih bolesnica s karcinomom dojke, dok se redovito postoperativno radiološko praćenje preporučuje u bolesnica s poštednom operacijom dojke i sa zdravom drugom dojkom. Mamografija je najraširenija metoda postoperativnog praćenja bolesnica. Zbog brojnih dokaza da povećava preţivljenje, mamografija je preporučena radiološka metoda u svim smjernicama. Ultrazvuk se u praćenju rijetko koristi, te ima ulogu u praćenju mlaĎih bolesnica i u analizi aksilarnih limfnih čvorova. Magnetska rezonanca je metoda visoke osjetljivosti koja se koristi u praćenju bolesnica, no nije zamjena za mamografiju. Kontrastna mamografija nije u rutinskoj primjeni za praćenje bolesnica s karcinomom dojke, no novija istraţivanja upućuju na njenu korist i moguću primjenu u budućnosti.Breast cancer is the most common malignant disease in the world and the leading cause of cancer mortality in women. In Croatia, breast cancer is the most common cancer in women and the third leading cause of cancer death. The incidence of breast cancer is increasing due to the presence of environmental risk factors. Due to advances in early diagnosis and treatment of breast cancer, mortality is decreasing and there is a growing need for adequate surveillance. The goal of routine surveillance is early detection of local recurrence, new primary tumor, and metastatic disease, which allows for treatment in the early stages of the disease and improves survival. Routine surveillance is necessary for all patients with breast cancer, while routine imaging surveillance is recommended for patients with breast-conserving surgery and a healthy opposite breast. Mammography is the most common method of surveillance after breast conserving surgery. Due to numerous evidence of increased survival rates, mammography is recommended as a radiological method by all guidelines. Ultrasound is rarely used in patient surveillance. However, it has a role in surveillance of young patients and evaluating axillary lymph nodes. Magnetic Resonance Imaging is a highly sensitive method used in patient monitoring, but it is not a substitute for mammography. Contrast mammography (CEM) is not routinely used in surveillance of breast cancer patients, but recent research suggests its potential benefits and possible future use