Does contrast-enhanced mammography have an impact on the detection of cancer in patients with risk of developing breast cancer?

Abstract

Background Contrast-enhanced mammography (CEM) has been discovered to be more sensitive and specific than two-dimensional full-field digital mammography (FFDM) in both screening and diagnostic settings. The aim of the study was to assess the additive role of CEM in the detection and characterization of breast lesions in women with increased risk of developing breast cancer. This prospective study included 283 female patients with increased risk of developing breast cancer (i.e., positive family history of breast cancer, personal history of breast cancer, and heterogeneously dense mammary parenchyma) coming for either screening (n = 127/283 (49.1%)) or diagnostic (n = 156/283 (55.1%)) purpose. All patients had FFDM and CEM done, and the findings were evaluated independently; final Breast Imaging Reporting And Data System (BIRADS) classification was given for each modality. Results were then compared with histopathology or ultrasound findings with routine follow-up for normal and typically benign findings. Results In this study, 283 women with mean age of 48 were enrolled. Among the studied cases regardless to a specific risk factor, 15/283 (5.3%) were diagnosed as normal, 13/283 (4.6%) as inflammatory lesions, 72/283(25.4%) as benign lesions, 6/283 (2.1%) as benign precancerous lesions, and 177/283 (62.5%) as malignant. The overall sensitivity and specificity of the CEM were 92.7 and 71.43 %, respectively, while FFDM were 80.90 and 59.05%, respectively. Conclusion Contrast-enhanced mammography is a valuable screening and diagnostic imaging modality in patients with increased risk of developing breast cancer with diagnostic indices higher than mammography resulting in a significantly higher cancer detection rate.

Contrast-Enhanced Digital Mammography Versus Digital Mammography in The Discrimination between Benign and Malignant Breast Lesions

“…Our study results regarding the superiority of CEDM over FFDM in the diagnosis of multifocality, multicentricity, and bilaterality of breast cancer matches those reported by Moustafa et al (16) who concluded that CEDM had an offered value in the preoperative assessment of breast masses by enhancing the accuracy of lesions identification and multiplicity and Hashem et al (17) reported that CEDM enhances the BI-RADS evaluation of malignant cases and it is also useful in the detection of multifocal and multicentric lesions.…”