Comparison of Contrast‐Enhanced Spectral Mammography and Contrast‐Enhanced MRI in Screening Multifocal and Multicentric Lesions in Breast Cancer Patients

Feng, Lei; Lei, Sheng; Zhang, Litao; Li, Na; Xie, Yuanzhong

doi:10.1155/2022/4224701

Cited by 8 publications

(14 citation statements)

References 24 publications

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“…In a further retrospective study of a highly selected group of 54 women already known to have multifocal or multicentric breast cancer [ 22 ], 188 lesions were found, of which 177 were cancers. No distinction was made between index and additional lesions and details regarding the method of imaging-pathology correlation were not described.…”

Section: Resultsmentioning

confidence: 99%

Contrast-enhanced mammography (CEM) versus MRI for breast cancer staging: detection of additional malignant lesions not seen on conventional imaging

et al. 2023

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Background Contrast-enhanced mammography (CEM) is more available than MRI for breast cancer staging but may not be as sensitive in assessing disease extent. We compared CEM and MRI in this setting. Methods Fifty-nine women with invasive breast cancer underwent preoperative CEM and MRI. Independent pairs of radiologists read CEM studies (after reviewing a 9-case set prior to study commencement) and MRI studies (with between 5 and 25 years of experience in breast imaging). Additional lesions were assigned National Breast Cancer Centre (NBCC) scores. Positive lesions (graded NBCC ≥ 3) likely to influence surgical management underwent ultrasound and/or needle biopsy. True-positive lesions were positive on imaging and pathology (invasive or in situ). False-positive lesions were positive on imaging but negative on pathology (high-risk or benign) or follow-up. False-negative lesions were negative on imaging (NBCC < 3 or not identified) but positive on pathology. Results The 59 women had 68 biopsy-proven malignant lesions detected on mammography/ultrasound, of which MRI demonstrated 66 (97%) and CEM 67 (99%) (p = 1.000). Forty-one additional lesions were detected in 29 patients: six of 41 (15%) on CEM only, 23/41 (56%) on MRI only, 12/41 (29%) on both; CEM detected 1/6 and MRI 6/6 malignant additional lesions (p = 0.063), with a positive predictive value (PPV) of 1/13 (8%) and 6/26 (23%) (p = 0.276). Conclusions While MRI and CEM were both highly sensitive for lesions detected at mammography/ultrasound, CEM may not be as sensitive as MRI in detecting additional otherwise occult foci of malignancy. Trial registration Australian and New Zealand Clinical Trials Registry: ACTRN 12613000684729

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Section: Resultsmentioning

confidence: 99%

Contrast-enhanced mammography (CEM) versus MRI for breast cancer staging: detection of additional malignant lesions not seen on conventional imaging

et al. 2023

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“…Feng et al (11) and Steinhof-Radwan ́ska et al ( 12) also confirmed that the specificity of CEM was higher than that of MRI, at 36.4% vs. 63.6% and 96.15% vs. 92.31%, respectively. By contrast, Moustafa et al (3) reported that CEM showed high sensitivity in multiple lesion detection, reaching 100%, but with a suboptimal specificity of approximately 97.3% because some benign lesions could show significant enhancement, such as in inflammatory lesions and intra-ductal papillomas.…”

Section: Discussionmentioning

confidence: 83%

“…It showed a good accuracy in multifocality and multicentricity assessment (9,10). The advantages of MRI include its ability to image the chest wall and axilla and the lack of ionizing radiation and breast compression (11). However, its limitations include its high cost, lengthy procedure, not being feasible in patients with claustrophobia and non-MR compatible cardiac devices, and a high rate of false-positive results, which may lead to more aggressive treatment plans than required, consequently affecting the patient's quality of life (12,13).…”

Section: Introductionmentioning

confidence: 99%

“…The main advantages of CEM include the provision of rapid treatment streaming, evaluation of suspicious microcalcifications and the availability of diverse diagnostic breast MRI resources for other purposes, such as supplementary screening, a relatively low cost, being directly available in the mammography unit without the need for a new appointment, and being sensitive to calcification. However, it requires the use of ionizing radiation, and breast cancers in the inner quadrants adjacent to the chest wall can be missed, leading to false negative results (11,13,14).…”

Section: Introductionmentioning

confidence: 99%

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Contrast-enhanced mammography versus breast MRI in the assessment of multifocal and multicentric breast cancer: a retrospective study

Hafez,

Zeinhom,

Hamed

et al. 2023

Acta Radiol

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Background Breast cancer multifocality and multicentricity diagnosis influences the surgeon's choice between applying breast conservative therapy or performing mastectomy. Purpose To assess the role of contrast enhanced mammography (CEM) and breast magnetic resonance imaging (MRI) in the assessment of preoperative breast cancer multifocality and multicentricity and to assess their accuracy, agreement and impact on the surgical management. Material and Methods The study retrospectively included cases over a 5-year period. After analysis and interpretation of suspicious breast lesions, a comparative evaluation of CEM and MRI was conducted with the assessment of diagnostic indices, including sensitivity, specificity and diagnostic accuracy. The kappa (κ) measure of agreement between both modalities was measured. The postoperative specimen pathology was the reference standard. Results One hundred and twenty-two female cases with 126 breast lesions were evaluated. Specimen pathology, MRI and CEM showed a single neoplastic lesion in 67.5%, 35% and 48.5% of cases, respectively, and multiple neoplastic lesions in 32.5%, 65% and 51.6% of cases, respectively. The sensitivity, specificity and accuracy of MRI were 95.12%, 49.41%,and 64.29%, and the CEM values were 85.37%, 64.71% and 71.43%, respectively. The κ value was 0.592 with an intermediate agreement between both modalities. When comparing between both modalities, enhancing foci showed a statistically significant difference, although there were no statistically significant difference in terms of high breast density or molecular subtype. Conclusion In terms of breast cancer multifocality and multicentricity evaluation, MRI showed a higher sensitivity, while CEM showed a higher specificity, and there was moderate agreement between the two modalities.

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“…Furthermore, examining the real impact of the most recent advancements in standard imaging techniques on breast cancer prevention, such as digital breast tomosynthesis (DBT) and automated breast ultrasound (ABUS), could be incredibly challenging, especially in women with dense breasts. In addition, contrast-enhanced spectral mammography (CESM) could be considered a true alternative to the most expensive magnetic resonance imaging (MRI) [ 10 , 11 ]. On the other hand, the evaluation of fast MRI could have a great impact on breast cancer prevention, especially in women at high risk [ 12 ].…”

mentioning

confidence: 99%

Special Issue “New Advances in Breast Imaging”

Tari

2022

Tomography

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Comparison of Contrast‐Enhanced Spectral Mammography and Contrast‐Enhanced MRI in Screening Multifocal and Multicentric Lesions in Breast Cancer Patients

Cited by 8 publications

References 24 publications

Contrast-enhanced mammography (CEM) versus MRI for breast cancer staging: detection of additional malignant lesions not seen on conventional imaging

Contrast-enhanced mammography (CEM) versus MRI for breast cancer staging: detection of additional malignant lesions not seen on conventional imaging

Contrast-enhanced mammography versus breast MRI in the assessment of multifocal and multicentric breast cancer: a retrospective study

Special Issue “New Advances in Breast Imaging”

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