Zarghami Anita, Mirmalek Seyed Abbas
Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Surgery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Galen Med J. 2024 Apr 22;13:e3340. doi: 10.31661/gmj.v13i.3340. eCollection 2024.
Breast cancer (BC) recurrence remains a concerning issue, requiring accurate identification and differentiation from primary lesions for optimal patient management. This comprehensive review aims to summarize and evaluate the current evidence on methods to distinguish primary breast tumors from recurrent lesions in patients with a history of BC. Also, we provide a comprehensive understanding of the different imaging techniques, including mammography, ultrasound, magnetic resonance imaging, and positron emission tomography, highlighting their diagnostic accuracy, limitations, and potential integration. In addition, the role of various biopsy modalities and molecular markers was explored. Furthermore, the potential role of liquid biopsy, circulating tumor cells, and circulating tumor DNA in differentiating between primary and recurrent BC was emphasized. Finally, it addresses emerging diagnostic modalities, such as radiomic analysis and artificial intelligence, which show promising potential in enhancing diagnostic accuracy. Through comprehensive analysis and review of the available literature, the current study provides an up-to-date understanding of the current state of knowledge, challenges, and future directions in accurately distinguishing between primary and recurrent breast lesions in patients with a history of BC.
乳腺癌（BC）复发仍是一个令人担忧的问题，为了实现对患者的最佳管理，需要准确识别并区分复发灶与原发灶。本综述旨在总结和评估目前关于区分有乳腺癌病史患者的原发性乳腺肿瘤与复发病变方法的证据。此外，我们全面介绍了包括乳腺X线摄影、超声、磁共振成像和正电子发射断层扫描在内的不同成像技术，突出了它们的诊断准确性、局限性以及潜在的综合应用。同时，探讨了各种活检方式和分子标志物的作用。此外，强调了液体活检、循环肿瘤细胞和循环肿瘤DNA在鉴别原发性和复发性乳腺癌中的潜在作用。最后，介绍了如影像组学分析和人工智能等新兴诊断方式，它们在提高诊断准确性方面显示出了巨大潜力。通过对现有文献的综合分析和综述，本研究提供了对有乳腺癌病史患者原发性和复发性乳腺病变准确鉴别方面的最新知识现状、挑战及未来方向的认识。
