Comparison of screening CEDM and MRI for women at increased risk for breast cancer: A pilot study

Jochelson, Maxine S.; Pinker, Katja; Dershaw, D. David; Hughes, Mary; Gibbons, Girard; Rahbar, Kareem; Robson, Mark E.; Mangino, Debra; Goldman, Debra A.; Moskowitz, Chaya S.; Morris, Elizabeth A.; Sung, Janice S.

doi:10.1016/j.ejrad.2017.10.001

Cited by 104 publications

(61 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The best results in terms of diagnostic performance were obtained by DCE‐MRI. Dynamic information obtained by time‐intensity curve including entire phase of contrast agent uptake allows a better detection and classification of breast lesions, but as already reported in literature, CEDM could be a supplemental imaging examination in women with an increased risk of breast cancer who do not meet MRI criteria or for whom access to MRI is limited …”

Section: Discussionmentioning

confidence: 97%

Digital breast tomosynthesis and contrast‐enhanced dual‐energy digital mammography alone and in combination compared to 2D digital synthetized mammography and MR imaging in breast cancer detection and classification

et al. 2019

View full text Add to dashboard Cite

To compare diagnostic performance of contrast-enhanced dual-energy digital mammography (CEDM) and digital breast tomosynthesis (DBT) alone and in combination compared to 2D digital mammography (MX) and dynamic contrast-enhanced MRI (DCE-MRI) in women with breast lesions. We enrolled 100 consecutive patients with breast lesions (BIRADS 3-5 at imaging or clinically suspicious). CEDM, DBT, and DCE-MRI 2D were acquired. Synthetized MX was obtained by DBT. A total of 134 lesions were investigated on 111 breasts of 100 enrolled patients: 53 were histopathologically proven as benign and 81 as malignant. Nonparametric statistics and receiver operating characteristic (ROC) curve were performed. Two-dimensional synthetized MX showed an area under ROC curve (AUC) of 0.764 (sensitivity 65%, specificity 80%), while AUC was of 0.845 (sensitivity 80%, specificity 82%) for DBT, of 0.879 (sensitivity 82%, specificity 80%) for CEDM, and of 0.892 (sensitivity 91%, specificity 84%) for CE-MRI. DCE-MRI determined an AUC of 0.934 (sensitivity 96%, specificity 88%). Combined CEDM with DBT findings, we obtained an AUC of 0.890 (sensitivity 89%, specificity 74%). A difference statistically significant was observed only between DCE-MRI and CEDM (P = .03). DBT, CEDM, CEDM combined to tomosynthesis, and DCE-MRI had a high ability to identify multifocal and bilateral lesions with a detection rate of 77%, 85%, 91%, and 95% respectively, while 2D synthetized MX had a detection rate for multifocal lesions of 56%. DBT and CEDM have superior diagnostic accuracy of 2D synthetized MX to identify and classify breast lesions, and CEDM combined with DBT has better diagnostic performance compared with DBT alone. The best results in terms of diagnostic performance were obtained by DCE-MRI. Dynamic information obtained by time-intensity curve including entire phase of contrast agent uptake allows a better detection and classification of breast lesions. | 861 PETRILLO ET aL.

show abstract

Section: Discussionmentioning

confidence: 97%

Digital breast tomosynthesis and contrast‐enhanced dual‐energy digital mammography alone and in combination compared to 2D digital synthetized mammography and MR imaging in breast cancer detection and classification

et al. 2019

View full text Add to dashboard Cite

show abstract

“…In preliminary studies, CESM shows cancer detection comparable to MRI, with improved specificity [118], though few data from screening are yet published. Jochelson et al [119] reported results from 307 women at increased risk who had screening CESM and MRI; 2 invasive cancers were seen on both modalities and one DCIS was seen only on MRI. PPV3 was 2/13 (15% for CESM) and 3/21 (14%) for MRI.…”

Section: Future Perspectivesmentioning

confidence: 99%

Breast density implications and supplemental screening

2018

View full text Add to dashboard Cite

Digital breast tomosynthesis (DBT) has been widely implemented in place of 2D mammography, although it is less effective in women with extremely dense breasts. Breast ultrasound detects additional early-stage, invasive breast cancers when combined with mammography; however, its relevant limitations, including the shortage of trained operators, operator dependence and small field of view, have limited its widespread implementation. Automated breast sonography (ABS) is a promising technique but the time to interpret and false positive rates need to be improved. Supplemental screening with contrast-enhanced magnetic resonance imaging (MRI) in high-risk women reduces late-stage disease; abbreviated MRI protocols may reduce cost and increase accessibility to women of average risk with dense breasts. Contrast-enhanced digital mammography (CEDM) and molecular breast imaging improve cancer detection but require further validation for screening and direct biopsy guidance should be implemented for any screening modality. This article reviews the status of screening women with dense breasts.

show abstract

“…In a comparative analysis to MRI in 2015, Contrast enhanced mammography (CEM) had equivalent if not better sensitivity (100% vs 93%) than MRI in detecting breast cancers [ 16 ]. Further papers have supported this finding, however has yet to be evaluated specifically in the setting of [ 17 , 18 ].…”

Section: Diagnostic Techniques and Their Effect On The Incidence And mentioning

confidence: 99%

Occult breast cancer: Where are we at?

Ofri¹,

Moore

2020

The Breast

View full text Add to dashboard Cite

Occult breast cancer (OBC) is described as an axillary metastatic carcinoma without detection of a primary breast lesion and is uncommon. Significant advances in breast imaging have occurred since its description, decreasing its incidence. However current management is based upon old studies, with variable clinical, radiological and pathological definitions of OBC. We suggest standardised definitions of OBC to facilitate more homogenous data representation in the literature. This review also discusses the conflicting heterogeneous data and its influence in determining the current management guidelines. We discuss whether the current significant surgical recommendations are necessary and postulate whether they could be safely substituted with less invasive management.

show abstract

Comparison of screening CEDM and MRI for women at increased risk for breast cancer: A pilot study

Cited by 104 publications

References 34 publications

Digital breast tomosynthesis and contrast‐enhanced dual‐energy digital mammography alone and in combination compared to 2D digital synthetized mammography and MR imaging in breast cancer detection and classification

Digital breast tomosynthesis and contrast‐enhanced dual‐energy digital mammography alone and in combination compared to 2D digital synthetized mammography and MR imaging in breast cancer detection and classification

Breast density implications and supplemental screening

Occult breast cancer: Where are we at?

Contact Info

Product

Resources

About