الفهرس 
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Abstract
Breast cancer (BC) is the predominant malignancy in the female population. Additionally, it is a significant determinant of mortality within that particular population.Significant progress in the domain of early detection and therapeutic interventions for breast cancer has resulted in enhanced patient outcomes. The observed advancements can be ascribed to the use of a holistic strategy that integrates surgical procedures, chemotherapy, and radiation therapy. Consequently, those who have been diagnosed with breast cancer now possess the capacity for prolonged durations of survival.The main obstacle encountered in BC management is to the reoccurrence of the disease at the local-regional level within the first five years, with the highest incidence found two years after surgical intervention in patients with BC.Based on available findings, the prompt detection of the recurrence of breast cancer not only aids in the management and treatment of the disease, but also improves the likelihood of survival following surgical intervention for affected patients.
Mammography and breast ultrasonography are widely acknowledged as the primary diagnostic modalities for breast cancer screening on a global level. In the realm of postoperative breast cancer surveillance, it is common to observe resemblances in the visual attributes of benign postoperative alterations and malignant recurrences. This similarity is particularly evident in cases with edematous, architectural distortion, and dense breast tissue, particularly among younger individuals. Therefore, it is essential to integrate supplementary courses focused on problem-solving to assist in precise diagnosis and differentiation.
Magnetic resonance imaging (MRI) is a diagnostic method known for its heightened sensitivity in the characterization of breast lesions. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a medical imaging modality that provides comprehensive visualization of breast morphology and enhancement kinetics. This facilitates the discernment of angiogenesis, a distinctive attribute of tumors.
Diffusion-weighted imaging (DWI) provides the advantage of being a succinct unenhanced scan that can be readily integrated into the existing clinical breast MRI protocols, potentially functioning as an additional tool that may be regularly used alongside conventional breast MRI. The main phenomenon detected in diffusion-weighted imaging (DWI) entails the random motion of water molecules within a non-restricted setting. The movement or diffusion of water throughout living organisms is constrained by the presence of internal and extracellular compartments, as well as the density of cells within tissues. A negative relationship can be observed between the degree of water diffusion in tissue and both tissue cellularity and the integrity of cell membranes.
The primary aim of this investigation was to assess the efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) and diffusion-weighted imaging (DWI) in differentiating between benign postoperative changes and recurrent breast carcinoma.
The present study comprised a cohort of thirty participants who had previously undergone breast surgery for the purpose of treating pathologically confirmed breast cancer. All participants were referred for histopathological examination. The histological examination indicated that 70% of the cases displayed benign postoperative changes, whereas the remaining 30% exhibited malignant recurrence.
When comparing the results of ultrasound and mammography with dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) and diffusion-weighted imaging (DWI), it was seen that the latter techniques exhibited a significant improvement in terms of sensitivity, specificity, and diagnostic accuracy.
In the current study, the mammography results were analyzed using the BIRADS classification method. The findings revealed a sensitivity of 44.4%, specificity of 95.2%, positive predictive value (PPV) of 80%, and negative predictive value (NPV) of 80%. The ultrasonography examination yielded a sensitivity rate of 66.7%, specificity rate of 95%, positive predictive value (PPV) of 93%, and negative predictive value (NPV) of 87.5%. The findings from the MRI examination revealed a sensitivity rate of 93%, specificity rate of 96%, positive predictive value (PPV) of 97%, and negative predictive value (NPV) of 95% in accurately differentiating between benign and malignant alterations subsequent to surgical intervention.
However, it is important to acknowledge that diffusion-weighted imaging (DWI) does possess several drawbacks, including its suboptimal spatial resolution and vulnerability to picture distortion. Nevertheless, when employed in conjunction with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), it may successfully discern the morphology and dynamic behavior of lesions. This capability is of utmost importance in differentiating postoperative changes from the reappearance of malignant tumors.