Evaluation of contrast-enhanced digital mammography (CEDM) in the preoperative staging of breast cancer: Large-scale single-center experience

Bicchierai, Giulia and Tonelli, Paolina and Piacenti, Alba and De Benedetto, Diego and Boeri, Cecilia and Vanzi, Ermanno and Bianchi, Simonetta and Cirone, Donatello and Gill, Maninderpal Kaur and Miele, Vittorio and Nori, Jacopo (2020) Evaluation of contrast-enhanced digital mammography (CEDM) in the preoperative staging of breast cancer: Large-scale single-center experience. Breast Journal, 26 (7). pp. 1276-1283. ISSN 1075-122X, DOI https://doi.org/10.1111/tbj.13766.

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One of the most important indications for contrast-enhanced breast imaging is the presurgical breast cancer (BC) staging. This is a large-scale single-center experience which evaluates the role of CEDM in presurgical staging and its impact on surgical planning. The aims of this retrospective study were to define the diagnostic performance of CEDM in the presurgical setting and to identify which types of patients could benefit from having CEDM. We selected 326 patients with BC who underwent CEDM as preoperative staging and had breast cancer-related surgery at our institution. We analyzed those cases in which CEDM led to additional imaging or biopsy and those in which it changed the type of surgery that was planned according to conventional breast imaging (CI) techniques (digital mammography, tomosynthesis and bilateral handheld ultrasound). CEDM sensitivity in identifying the index lesion and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy in the correct preoperative staging of BC of the whole population and in various subgroups were calculated. CEDM sensitivity for the index lesion was 98.8% (322/326), which led to additional breast imaging in 23.6% (77/326) of patients and additional biopsies in 17.5% (57/326). CEDM changed the type of surgery in 18.4% (60/326). In the preoperative breast cancer staging, CEDM sensitivity, specificity, PPV, NPV, and accuracy produced results of 93%, 98%, 90%, 98%, and 97%, respectively. CEDM performance was better in patients with palpable lesions. CEDM has an excellent diagnostic performance in the presurgical staging of BC. Symptomatic patients with palpable lesions benefitted most from preoperative CEDM, with a statistically significant difference compared with nonpalpable.

Item Type: Article
Uncontrolled Keywords: Breast cancer; Contrast-enhanced digital mammography; Conventional breast imaging techniques; Digital mammography; Presurgical staging
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: Universiti Malaya Medical Centre (UMMC)
Depositing User: Ms Zaharah Ramly
Date Deposited: 20 Dec 2022 00:45
Last Modified: 20 Dec 2022 00:45
URI: http://eprints.um.edu.my/id/eprint/36943

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