The Role of Ultrasound in Detecting Residual or Recurrent Breast Carcinoma: A Case Report of a Patient Following Wide Excision in the Contralateral Breast

Main Article Content

Andini Sangkal
Rahmawati
Pither Sandy Tulak

Abstract

Breast carcinoma represents the most prevalent malignancy among women, rendering routine surveillance using ultrasonography (USG) essential for early detection and monitoring. This case report describes a 49-year-old female presenting with a palpable mass and pain in the left breast, occurring one year after undergoing wide excision in the right breast, with prior histopathological findings of microglandular adenosis. Physical examination revealed bilateral breast masses without evidence of axillary lymphadenopathy. Breast ultrasonography demonstrated a cystic lesion with a solid component in the right breast and a cystic lesion in the left breast, both classified as BI-RADS III. This case underscores the critical role of post–wide excision surveillance using ultrasonography in identifying residual or recurrent lesions in the breast, including the contralateral side. Consistent monitoring and an appropriate clinical approach are expected to prevent diagnostic delays and improve clinical outcomes in patients with residual or recurrent breast lesions.

Article Details

How to Cite
Sangkal, A., Rahmawati, R., & Tulak, P. S. (2026). The Role of Ultrasound in Detecting Residual or Recurrent Breast Carcinoma: A Case Report of a Patient Following Wide Excision in the Contralateral Breast. Journal of Community Health Provision, 6(1), 178-185. https://doi.org/10.55885/jchp.v6i1.957
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References

Adam, R., Haileselassie, W., Solomon, N., Desalegn, Y., Tigeneh, W., Suga, Y., & Gebremedhin, S. (2023). Nutritional Status and Quality of Life Among Breast Cancer Patients Undergoing Treatment in Addis Ababa, Ethiopia. BMC Women’s Health, 23(1), 428. https://doi.org/10.1186/s12905-023-02585-9

Alshafie, M., Soqia, J., Alhomsi, D., Alameer, M. B., Agha, L. Y., & Saifo, M. (2024). Knowledge and Practice of Breast Self-Examination among Breast Cancer Patients in Damascus, Syria. BMC Women’s Health, 24(1), 73. https://doi.org/10.1186/s12905-024-02912-8

Amafah, J., Temedie-Asogwa, T., Atta, J. A., & Al Zoubi, M. A. M. (2023). The Impacts of Treatment Summaries on Patient-Centered Communication and Quality of Care for Cancer Survivors. Int. J. Med All Body Heal. Res, 4(10.54660).

Arnold, M., Morgan, E., Rumgay, H., Mafra, A., Singh, D., Laversanne, M., ... & Soerjomataram, I. (2022). Current and future burden of breast cancer: Global statistics for 2020 and 2040. The breast, 66, 15-23. https://doi.org/10.1016/j.breast.2022.08.010

Arzanova, E., & Mayrovitz, H. N. (2022). The epidemiology of breast cancer. Exon publications, 1-19. https://doi.org/10.36255/exon-publications-breast-cancer-epidemiology

Atashzadeh-Shoorideh, F., Mohtashami, J., Farhadzadeh, M., Sanaie, N., Zadeh, E. F., Beykmirza, R., & Abdoljabari, M. (2021). Humanitarian care: facilitator of communication between the patients with cancer and nurses. Nursing Practice Today, 8(1), 70-78. https://doi.org/10.18502/npt.v8i1.4493

Athanasiou, A., Aubert, E., Salomon, A. V., & Tardivon, A. (2014). Complex cystic breast masses in ultrasound examination. Diagnostic and interventional imaging, 95(2), 169-179.

Awali, M., Middleton, W. D., Daggumati, L., Phillips, C. H., Caserta, M. P., Fetzer, D. T., ... & Itani, M. (2024). Ultrasound of palpable lesions: a pictorial review. Abdominal Radiology, 49(10), 3574-3598. https://doi.org/10.1007/s00261-024-04249-0

Bedrosian, I., Somerfield, M. R., Achatz, M. I., Boughey, J. C., Curigliano, G., Friedman, S., Kohlmann, W. K., Kurian, A. W., Laronga, C., Lynce, F., Norquist, B. S., Plichta, J. K., Rodriguez, P., Shah, P. D., Tischkowitz, M., Wood, M., Yadav, S., Yao, K., & Robson, M. E. (2024). Germline Testing in Patients With Breast Cancer: ASCO–Society of Surgical Oncology Guideline. Journal of Clinical Oncology, 42(5), 584–604. https://doi.org/10.1200/JCO.23.02225

Beynon, A. M., Hebert, J. J., & Walker, B. F. (2018). The interrater reliability of static palpation of the thoracic spine for eliciting tenderness and stiffness to test for a manipulable lesion. Chiropractic & Manual Therapies, 26(1), 49. https://doi.org/10.1186/s12998-018-0218-7

Biparva, A. J., Raoofi, S., Rafiei, S., Masoumi, M., Doustmehraban, M., Bagheribayati, F., Shahrebabak, E. sadat V., Mejareh, Z. N., Khani, S., Abdollahi, B., Bafrajard, Z. A., Beidokhti, S. S., Shojaei, S. F., Rastegar, M., Kan, F. P., Sanjabad, E. N., & Ghashghaee, A. (2023). Global Depression in Breast Cancer Patients: Systematic Review and Meta-Analysis. Plos One, 18(7), e0287372. https://doi.org/10.1371/journal.pone.0287372

Dumitrescu, R. G., & Cotarla, I. J. J. O. C. (2005). Understanding breast cancer risk‐where do we stand in 2005?. Journal of cellular and molecular medicine, 9(1), 208-221. https://doi.org/10.1111/j.1582-4934.2005.tb00350.x

Dvir, K., Giordano, S., & Leone, J. P. (2024). Immunotherapy in Breast Cancer. International Journal of Molecular Sciences, 25(14), 7517. https://doi.org/10.3390/ijms25147517

Ficarra, S., Thomas, E., Bianco, A., Gentile, A., Thaller, P., Grassadonio, F., Papakonstantinou, S., Schulz, T., Olson, N., Martin, A., Wagner, C., Nordström, A., & Hofmann, H. (2022). Impact of Exercise Interventions on Physical Fitness in Breast Cancer Patients and Survivors: A Systematic Review. Breast Cancer, 29(3), 402–418. https://doi.org/10.1007/s12282-022-01347-z

Gray, J., Evans, N., Taylor, B., Rizzo, J., & Walker, M. (2009). State of the evidence: the connection between breast cancer and the environment. International journal of occupational and environmental health, 15(1), 43-78.

Harirchi, I., Karbakhsh, M., Hadi, F., Madani, S. S., Sirati, F., & Kolahdoozan, S. (2015). Patient delay, diagnosis delay and treatment delay for breast cancer: comparison of the pattern between patients in public and private health sectors. Archives of Breast Cancer, 52-57. https://doi.org/10.19187/abc.20152252-57

Heidary, Z., Ghaemi, M., Rashidi, B. H., Gargari, O. K., & Montazeri, A. (2023). Quality of Life in Breast Cancer Patients: A Systematic Review of the Qualitative Studies. Cancer Control, 30. https://doi.org/10.1177/10732748231168318

Heryanto, B., Winarti, N. W., Saputra, H., Dewi, I. G. A. S. M., Mahastuti, N. M., & Muliarta, I. M. (2025). Differences In Stromal Tils Grade and Pd-L1 Expression In Tnbc And Non-Tnbc At Prof. Dr. Igng Ngoerah General Hospital. E-Jurnal Medika Udayana, 14(8), 7-16.

Kamińska, M., Ciszewski, T., Łopacka-Szatan, K., Miotła, P., & Starosławska, E. (2015). Breast cancer risk factors. Menopause Review/Przegląd Menopauzalny, 14(3), 196-202. https://doi.org/10.5114/pm.2015.54346

Katsura, C., Ogunmwonyi, I., Kankam, H. K., & Saha, S. (2022). Breast Cancer: Presentation, Investigation and Management. British Journal of Hospital Medicine, 83(2), 1–7. https://doi.org/10.12968/hmed.2021.0459

Khoirunnisa, S. M., Setiawan, D., Postma, M. J., & de Jong, L. A. (2025). Trends in breast cancer in Indonesia from 2017 to 2020: A national-level analysis by age and disease severity. Cancer treatment and research communications, 101000. https://doi.org/10.1016/j.ctarc.2025.101000

Khoshnazar, T. A. K., Rassouli, M., Akbari, M. E., Lotfi-Kashani, F., Momenzadeh, S., Rejeh, N., & Mohseny, M. (2016). Communication needs of patients with breast cancer: A qualitative study. Indian journal of palliative care, 22(4), 402. https://doi.org/10.4103/0973-1075.191763

Khurram, I., Khan, M. U., Ibrahim, S., Saleem, A., Khan, Z., Mubeen, M., Khawar, A., & Ali, Q. (2023). Efficacy of Cell-Free DNA as a Diagnostic Biomarker in Breast Cancer Patients. Scientific Reports, 13(1), 15347. https://doi.org/10.1038/s41598-023-42726-6

Kristina, S. A., Krisnadewi, K. I., Trung, V. Q., Ramadhani, A., Verdiana, A. S., & Aryasatya, M. D. (2025). Cancer Burden Across The South East Asia Nation (ASEAN) in 2022. Asian Pacific Journal of Cancer Prevention: APJCP, 26(9), 3377. https://doi.org/10.31557/APJCP.2025.26.9.3377

Kunkler, I. H., Williams, L. J., Jack, W. J. L., Cameron, D. A., & Dixon, J. M. (2023). Breast-Conserving Surgery with or without Irradiation in Early Breast Cancer. New England Journal of Medicine, 388(7), 585–594. https://doi.org/10.1056/NEJMoa2207586

Lanng, C., Hoffmann, J., Galatius, H., & Engel, U. (2007). Assessment of clinical palpation of the axilla as a criterion for performing the sentinel node procedure in breast cancer. European Journal of Surgical Oncology (EJSO), 33(3), 281-284. https://doi.org/10.1016/j.ejso.2006.09.032

Lev, S., & Lev, M. H. (2000). Imaging of cystic lesions. Radiologic Clinics of North America, 38(5), 1013-1027. https://doi.org/10.1016/S0033-8389(05)70218-9

Li, Y., Fang, C., Xiong, M., Hou, H., Zhang, Y., & Zhang, C. (2024). Exploring Fear of Cancer Recurrence and Related Factors Among Breast Cancer Patients: A Cross‐Sectional Study. Journal of Advanced Nursing, 80(6), 2403–2414. https://doi.org/10.1111/jan.16009

Musu, D., Rossi-Fedele, G., Campisi, G., & Cotti, E. (2016). Ultrasonography in the diagnosis of bone lesions of the jaws: a systematic review. Oral surgery, oral medicine, oral pathology and oral radiology, 122(1), e19-e29. https://doi.org/10.1016/j.oooo.2016.03.022

Osborne, A., Adnani, Q. E. S., & Ahinkorah, B. O. (2025). Breast cancer incidence in Indonesia: a sex-disaggregated analysis using WHO health equity assessment toolkit data. BMC cancer, 25(1), 986. https://doi.org/10.1186/s12885-025-14332-4

Pinheiro, D. J. P. D. C., Elias, S., & Nazário, A. C. P. (2014). Axillary lymph nodes in breast cancer patients: sonographic evaluation. Radiologia brasileira, 47, 240-244.

Prades, J., Ferro, T., Gil, F., & Borras, J. M. (2014). Core communication components along the cancer care process: The perspective of breast cancer patients. The Breast, 23(5), 617-622. https://doi.org/10.1016/j.breast.2014.06.001

Qi, X., Qiao, B., Song, T., Huang, D., Zhang, H., Liu, Y., Jin, Q., Yang, M., & Liu, D. (2023). Clinical Utility of The Pan-Immune-Inflammation Value in Breast Cancer Patients. Frontiers in Oncology, 13. https://doi.org/10.3389/fonc.2023.1223786

Reimer, T., Stachs, A., Veselinovic, K., Kühn, T., Heil, J., Polata, S., Marmé, F., Müller, T., Hildebrandt, G., Krug, D., Ataseven, B., Reitsamer, R., Ruth, S., Denkert, C., Bekes, I., Zahm, D.-M., Thill, M., Golatta, M., Holtschmidt, J., … Gerber, B. (2025). Axillary Surgery in Breast Cancer — Primary Results of the INSEMA Trial. New England Journal of Medicine, 392(11), 1051–1064. https://doi.org/10.1056/NEJMoa2412063

Rinaldi, I. (2024). The Comprehensive cancer management as an effort to improve the quality of cancer care in Indonesia towards a Golden Indonesia 2045. The Indonesian Journal of Cancer Control, 3(3), 129-145. https://doi.org/10.52830/inajcc.v3i3.110

Rivera-Franco, M. M., & Leon-Rodriguez, E. (2018). Delays in breast cancer detection and treatment in developing countries. Breast cancer: basic and clinical research, 12, 1178223417752677. https://doi.org/10.1177/1178223417752677

Shetty, M. K., & Carpenter, W. S. (2004). Sonographic evaluation of isolated abnormal axillary lymph nodes identified on mammograms. Journal of ultrasound in medicine, 23(1), 63-71. https://doi.org/10.7863/jum.2004.23.1.63

Smolarz, B., Nowak, A. Z., & Romanowicz, H. (2022). Breast cancer—epidemiology, classification, pathogenesis and treatment (review of literature). Cancers, 14(10), 2569. https://doi.org/10.3390/cancers14102569

Soh, J. Y., Yahya, M. M., Bachok, N. A., Wan Zain, W. Z., Wong, M. P. K., Zakaria, Z., ... & Mohamad, I. S. (2022). Factors associated with delay in seeking care for breast symptoms. BMC women's health, 22(1), 316. https://doi.org/10.1186/s12905-022-01898-5

Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660

Tao, Z., Shi, A., Lu, C., Song, T., Zhang, Z., & Zhao, J. (2015). Breast cancer: epidemiology and etiology. Cell biochemistry and biophysics, 72(2), 333-338. https://doi.org/10.1007/s12013-014-0459-6

Van Zee, K. J., Subhedar, P., Olcese, C., Patil, S., & Morrow, M. (2015). Relationship between margin width and recurrence of ductal carcinoma in situ: analysis of 2996 women treated with breast-conserving surgery for 30 years. Annals of surgery, 262(4), 623-631.

Vegunta, S., Lester, S. P., Pruthi, S., & Mussallem, D. M. (2020). Effects of major lifestyle factors on breast cancer risk: impact of weight, nutrition, physical activity, alcohol and tobacco. Breast Cancer Management, 9(4), BMT51. https://doi.org/10.2217/bmt-2020-0033

Winters, S., Martin, C., Murphy, D., & Shokar, N. K. (2017). Breast cancer epidemiology, prevention, and screening. Progress in molecular biology and translational science, 151, 1-32.

Xiong, X., Zheng, L.-W., Ding, Y., Chen, Y.-F., Cai, Y.-W., Wang, L.-P., Huang, L., Liu, C.-C., Shao, Z.-M., & Yu, K.-D. (2025). Breast Cancer: Pathogenesis and Treatments. Signal Transduction and Targeted Therapy, 10(1), 49. https://doi.org/10.1038/s41392-024-02108-4

Yang, Y., Sun, H., Luo, X., Li, W., Yang, F., Xu, W., Ding, K., Zhou, J., Liu, W., Garg, S., Jackson, T., Chen, Y., & Xiang, Y.-T. (2022). Network Connectivity Between Fear of Cancer Recurrence, Anxiety, and Depression in Breast Cancer Patients. Journal of Affective Disorders, 309, 358–367. https://doi.org/10.1016/j.jad.2022.04.119