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Contrast enhanced mammography in breast cancer surveillance.
- Source :
-
Breast cancer research and treatment [Breast Cancer Res Treat] 2023 Jun; Vol. 199 (2), pp. 221-230. Date of Electronic Publication: 2023 Mar 25. - Publication Year :
- 2023
-
Abstract
- Purpose: Mammography (MG) is the standard imaging in surveillance of women with a personal history of breast cancer or DCIS (PHBC), supplemented with ultrasound. Contrast Enhanced Mammography (CEM) has higher sensitivity than MG and US. We report the performance of CEM compared with MG ± US.<br />Methods: A retrospective study of patients undergoing their first surveillance CEM in an Australian hospital setting between June 2006 and October 2020. Cases where a patient was recalled for assessment were identified, recording radiology, pathology and treatment details. Blinded re-reading of recalled cases was performed to determine the contribution of contrast. Use of surveillance US across the board was assessed for the period.<br />Results: 73/1191 (6.1%) patients were recalled. 35 (48%) were true positives (TP), with 26 invasive cancers and 9 cases of DCIS, while 38 (52%) were false positive (FP) with a positive predictive value (PPV) 47.9%. 32/73 were recalled due to MG findings, while 41/73 were only recalled due to Contrast. 14/73 had 'minimal signs' with a lesion identifiable on MG with knowledge of the contrast finding, while 27/73 were visible only with contrast. 41% (17/41) recalled due to contrast were TP. Contrast-only TPs were found with low and high mammographic density (MD). Screening breast US reduced by 55% in the year after CEM was implemented.<br />Conclusion: Compared to MG, CEM as a single surveillance modality for those with PHBC has higher sensitivity and comparable specificity, identifying additional malignant lesions that are clinically significant. Investigation of interval cancer and subsequent round outcomes is warranted.<br /> (© 2023. The Author(s).)
- Subjects :
- Female
Humans
Retrospective Studies
Sensitivity and Specificity
Early Detection of Cancer methods
Australia epidemiology
Mammography methods
Breast pathology
Contrast Media
Breast Neoplasms diagnostic imaging
Breast Neoplasms epidemiology
Carcinoma, Intraductal, Noninfiltrating diagnostic imaging
Carcinoma, Intraductal, Noninfiltrating epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7217
- Volume :
- 199
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Breast cancer research and treatment
- Publication Type :
- Academic Journal
- Accession number :
- 36966271
- Full Text :
- https://doi.org/10.1007/s10549-023-06916-0