Diagnostic efficacy of contrast-enhanced breast MRI versus X-ray mammography in women with different degrees of breast density

Barkhausen, Jörg; Bischof, Arpad; Haverstock, Daniel; Klemens, Mark; Brueggenwerth, Guenther; Weber, Olaf; Endrikat, Jan

doi:10.1177/0284185120936271

Cited by 6 publications

(10 citation statements)

References 48 publications

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“…The main techniques used for identification of breast lesions are ultrasound, mammography, and magnetic resonance imaging (MRI). MRI offers better sensitivity and specificity than mammography and ultrasonography, especially for lesions in dense breasts ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Application of Diffusion Weighted Imaging Techniques for Differentiating Benign and Malignant Breast Lesions

Ruan

et al. 2021

Front. Oncol.

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To explore the value of apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM), and diffusional kurtosis imaging (DKI) based on diffusion weighted magnetic resonance imaging (DW-MRI) in differentiating benign and malignant breast lesions. A total of 215 patients with breast lesions were prospectively collected for breast MR examination. Single exponential, IVIM, and DKI models were calculated using a series of b values. Parameters including ADC, perfusion fraction (f), tissue diffusion coefficient (D), perfusion-related incoherent microcirculation (D*), average kurtosis (MK), and average diffusivity (MD) were compared between benign and malignant lesions. ROC curves were used to analyze the optimal diagnostic threshold of each parameter, and to evaluate the diagnostic efficacy of single and combined parameters. ADC, D, MK, and MD values were significantly different between benign and malignant breast lesions (P<0.001). Among the single parameters, ADC had the highest diagnostic efficiency (sensitivity 91.45%, specificity 82.54%, accuracy 88.84%, AUC 0.915) and the best diagnostic threshold (0.983 μm2/ms). The combination of ADC and MK offered high diagnostic performance (sensitivity 90.79%, specificity 85.71%, accuracy 89.30%, AUC 0.923), but no statistically significant difference in diagnostic performance as compared with single-parameter ADC (P=0.268). The ADC, D, MK, and MD parameters have high diagnostic value in differentiating benign and malignant breast lesions, and of these individual parameters the ADC has the best diagnostic performance. Therefore, our study revealed that the use of ADC alone should be useful for differentiating between benign and malignant breast lesions, whereas the combination of MK and ADC might improve the diagnostic performance to some extent.

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Section: Introductionmentioning

confidence: 99%

Application of Diffusion Weighted Imaging Techniques for Differentiating Benign and Malignant Breast Lesions

Ruan

et al. 2021

Front. Oncol.

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“…High breast density is a common risk factor for breast cancer. Dense breasts have a 2.92–4.24 times higher risk of breast cancer than fatty breasts 21,22 . Not only do high‐density breasts have a low contrast with lesions, but the superposition of dense breast tissue reduces the sensitivity of mammographic diagnosis significantly 23 .…”

Section: Discussionmentioning

confidence: 99%

“…Dense breasts have a 2.92–4.24 times higher risk of breast cancer than fatty breasts. 21 , 22 Not only do high‐density breasts have a low contrast with lesions, but the superposition of dense breast tissue reduces the sensitivity of mammographic diagnosis significantly. 23 Multiple studies have shown that the sensitivity of mammography to breast cancer decreases with increasing breast density.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of contrast‐enhanced mammography for suspicious findings in dense breasts: A systematic review and meta‐analysis

Lin,

Li,

et al. 2024

Cancer Medicine

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PurposeContrast‐enhanced spectral imaging (CEM) is a new mammography technique, but its diagnostic value in dense breasts is still inconclusive. We did a systematic review and meta‐analysis of studies evaluating the diagnostic performance of CEM for suspicious findings in dense breasts.Materials and MethodsThe PubMed, Embase, and Cochrane Library databases were searched systematically until August 6, 2023. Prospective and retrospective studies were included to evaluate the diagnostic performance of CEM for suspicious findings in dense breasts. The QUADAS‐2 tool was used to evaluate the quality and risk of bias of the included studies. STATA V.16.0 and Review Manager V.5.3 were used to meta‐analyze the included studies.ResultsA total of 10 studies (827 patients, 958 lesions) were included. These 10 studies reported the diagnostic performance of CEM for the workup of suspicious lesions in patients with dense breasts. The summary sensitivity and summary specificity were 0.95 (95% CI, 0.92–0.97) and 0.81 (95% CI, 0.70–0.89), respectively. Enhanced lesions, circumscribed margins, and malignancy were statistically correlated. The relative malignancy OR value of the enhanced lesions was 28.11 (95% CI, 6.84–115.48). The relative malignancy OR value of circumscribed margins was 0.17 (95% CI, 0.07–0.45).ConclusionCEM has high diagnostic performance in the workup of suspicious findings in dense breasts, and when lesions are enhanced and have irregular margins, they are often malignant.

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“…The main results 6 and analyses by breast density were published elsewhere. 27 The evaluation was done on a pooled database of 2 large Phase III studies.…”

Section: Discussionmentioning

confidence: 99%

Sensitivity of Contrast-Enhanced Breast MRI vs X-ray Mammography Based on Cancer Histology, Tumor Grading, Receptor Status, and Molecular Subtype: A Supplemental Analysis of 2 Large Phase III Studies

Endrikat

Schmidt

Haverstock

et al. 2022

Breast Cancer�(Auckl)

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Background: The impact of certain tumor parameters on the sensitivity of imaging tools is unknown. The purpose was to study the impact of breast cancer histology, tumor grading, single receptor status, and molecular subtype on the sensitivity of contrast-enhanced breast magnetic resonance imaging (CE-BMRI) vs X-ray mammography (XRM) to detect breast cancer. Materials and Methods: We ran a supplemental analysis of 2 global Phase III studies which recruited patients with histologically proven breast cancers. The sensitivity of CE-BMRI vs XRM to detect cancer lesions with different histologies, tumor grading, single receptor status, and molecular subtype was compared. Six blinded readers for each study evaluated the images. Results were summarized as the “Mean Reader.” For each reader, sensitivity was defined as the proportion of detected lesions vs the total number of lesions identified by the standard of reference. Two-sided 95% confidence intervals were calculated for within-group proportions, and for the difference between CE-BMRI and XRM, using a normal approximation to the binomial distribution. Results: In 778 patients, 1273 cancer lesions were detected. A total of 435 patients had 1 lesion, 254 had 2 lesions, and 77 had 3 or more lesions. The sensitivity of CE-BMRI was significantly higher compared with XRM irrespective of the histology. The largest difference was seen for invasive lobular carcinoma (22.3%) and ductal carcinoma in situ (19%). Across all 3 tumor grades, the sensitivity advantage of CE-BMRI over XRM ranged from 15.7% to 18.5%. Contrast-enhanced breast magnetic resonance imaging showed higher sensitivity compared with XRM irrespective of single receptor expressions (15.3%-19.4%). The sensitivities for both imaging methods were numerically higher for the more aggressive ER– (estrogen receptor), PR– (progesterone receptor), and HER2+ (human epidermal growth factor receptor 2) tumors. Irrespective of molecular subtype, sensitivity of CE-BMRI was 14.8% to 18.9% higher compared with XRM. Conclusions: Contrast-enhanced breast magnetic resonance imaging showed significantly higher sensitivity compared with XRM independent of tumor histology, tumor grading, single receptor status, and molecular subtype. Trial Registration: ClinicalTrials.gov: NCT01067976 and NCT01104584.

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Diagnostic efficacy of contrast-enhanced breast MRI versus X-ray mammography in women with different degrees of breast density

Cited by 6 publications

References 48 publications

Application of Diffusion Weighted Imaging Techniques for Differentiating Benign and Malignant Breast Lesions

Application of Diffusion Weighted Imaging Techniques for Differentiating Benign and Malignant Breast Lesions

Diagnostic performance of contrast‐enhanced mammography for suspicious findings in dense breasts: A systematic review and meta‐analysis

Sensitivity of Contrast-Enhanced Breast MRI vs X-ray Mammography Based on Cancer Histology, Tumor Grading, Receptor Status, and Molecular Subtype: A Supplemental Analysis of 2 Large Phase III Studies

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