To develop the method of standardized dynamic ultrasound (US) for hypoechoic post-surgical scar follow-up and to assess its value in the detection of breast cancers located in the area of the scar tissue.

Material and methods. 263 women (19-78 years old; mean — 47.3±20.3) after one or more previous breast surgeries. The follow-up started 0.5-55 years after the surgery (mean — 18 years) and continued with 6 months intervals. The minimal follow-up duration required for inclusion to the analysis was 3 years.

Results. The post-surgical scar had hyperechoic appearance in 89.7% of cases (236 patients), that made possible to visualize hypoechoic malignant lesions on this background relatively easily. However in 10.3% of cases (27 patients) we found hypoechoic scar and the conventional US sensitivity in the breast cancer detection in this area was 50%. At the same time, the proposed method of standardized quantitative US raised the overall sensitivity in such cases to 100%.

High prevalence of breast surgery (including performed for benign lesions), risk of malignant post-surgical scar transformation as well as both high cost and limitations of alternative modalities (contrast-enhanced magnetic resonance imaging) makes the proposed method of dynamic US scanning reasonable to perform.

Conclusion. The follow-up strategy including the proposed method of standardized quantitative US and performed every 6 month increases the overall US sensitivity in breast cancer detection in the area of scar.