ARRS 2022 Abstracts

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2107. Screening Ultrasound of the Chest Wall in the Mastectomy Patient
Authors * Denotes Presenting Author
  1. Ashley Bragg *; University of Texas MD Anderson Cancer Center
  2. Megan Speer; University of Texas MD Anderson Cancer Center
  3. Kyungmin Shin; University of Texas MD Anderson Cancer Center
  4. Hannah Chung; University of Texas MD Anderson Cancer Center
  5. Jia Sun; University of Texas MD Anderson Cancer Center
  6. Jessica Leung; University of Texas MD Anderson Cancer Center
Objective:
This study aims to assess the utility of ultrasound (US) in the screening/surveillance evaluation of the chest wall after mastectomy.

Materials and Methods:
This was an IRB-approved, retrospective study on screening US examinations of the chest wall after mastectomy from January 2016–January 2017. US of the chest wall includes a minimum of two orthogonal sonographic views from the clavicles superiorly to the upper abdomen inferiorly and from the sternum medially to the mid axillary line laterally. Cases of known chest wall recurrence were excluded. All patients had at least 1 year of clinical or imaging follow-up. Patients were asymptomatic and presented for screening or surveillance ultrasound with no complaints. Thirty-three (11.2%) exams were performed with history of contralateral malignancy, 262 (88.5%) exams were performed with history of ipsilateral malignancy, and 1 (0.3%) exam was performed in a patient with bilateral prophylactic mastectomy.

Results:
During the 13-month study, there were 296 screening US examinations in 237 patients with mastectomy (median 56 years, range 25–85 years). Of these, 105 (35.4%) had reconstruction with implant, 52 (17.6%) reconstruction with autologous flap, 7 (2.4%) with combined flap and implant, and 132 (44.6%) were without reconstruction. There were 293 exams (99.0%) with normal or reported benign findings. Three exams (1.0%) were considered suspicious, with recommendation for biopsy. Fine needle aspiration (FNA) biopsy was performed in each suspicious case, and all yielded benign results. No chest wall malignancies were detected. One biopsy yielded fat necrosis, one yielded reparative change, and one yielded cystic content.

Conclusion:
Of 296 chest wall screening/surveillance US examinations performed for patients with mastectomy, no malignancies were detected. Although a targeted or diagnostic chest wall US may be indicated based on symptoms or clinical concern, screening/surveillance chest wall US in asymptomatic patients with mastectomy is not indicated.