Head-to-head comparison of contrast-enhanced mammography and contrast-enhanced MRI for assessing pathological complete response to neoadjuvant therapy in patients with breast cancer: a meta-analysis

Kaiyin, Min; Lingling, Tong; Leilei, Tang; Wenjia, Li; Bin, Ji

doi:10.1007/s10549-023-07034-7

Cited by 9 publications

(1 citation statement)

References 35 publications

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“…This, reassuringly, does not constitute a major limitation, as the literature suggests that MRI is not superior to ultrasonography when assessing the response in the breast 31 , 32 or the axilla 33 . Moreover, a recent meta-analysis suggests that contrast-enhanced mammography, a modality that does not interfere with SPIO, seems to yield comparable diagnostic accuracy to MRI during PST 34 . Thus, the potential of axillary mapping with SPIO before PST should be explored, especially in light of the findings of the present study.…”

Section: Discussionmentioning

confidence: 99%

Magnetically guided surgery after primary systemic therapy for breast cancer: implications for enhanced axillary mapping

Pantiora,

Eriksson,

Wärnberg

et al. 2024

British Journal of Surgery

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Background Superparamagnetic iron nanoparticles perform comparably to radioisotope ± blue dye for sentinel lymph node detection in breast cancer, even when injected up to 8 weeks before surgery. Using superparamagnetic iron nanoparticles for sentinel lymph node detection after primary systemic therapy, and the maximum time frame of superparamagnetic iron nanoparticle administration have not been investigated. Methods This cohort study included cN0/1-to-ycN0 patients undergoing sentinel lymph node detection or targeted axillary dissection. All patients received superparamagnetic iron nanoparticles either before primary systemic therapy or before surgery, and radioisotope on the day of surgery. Results For 113 patients analysed, superparamagnetic iron nanoparticles were injected a median of 3 (range 0–248) days before surgery, with a 97.4% detection rate compared with 91.2% for radioisotope (P = 0.057). Concordance for radioisotope was 97.1% and this was not affected by timing of superparamagnetic iron nanoparticle injection (Kendall’s tau 0.027; P = 0.746). The median sentinel lymph node yield was 3 (interquartile range (i.q.r.) 2–3) for superparamagnetic iron nanoparticles and 2 (i.q.r. 2–3) for radioisotope (P < 0.001). In targeted axillary dissection, detection was 100% for superparamagnetic iron nanoparticles and 81.8% for radioisotope (P = 0.124). The index node was magnetic in 93.9% and radioactive in 66.7% (P = 0.007), an outcome that was not affected by any factors. For patients with metastases, superparamagnetic iron nanoparticle detection was 100% and radioisotope-based detection was 84.2% (P = 0.083), with superparamagnetic iron nanoparticles detecting more metastatic sentinel lymph nodes (median of 1 (i.q.r. 1–2) for superparamagnetic iron nanoparticles compared with a median of 1 (i.q.r. 0–1) for radioisotope; P = 0.005). Conclusion Injection before primary systemic therapy is feasible and does not affect concordance with radioisotope. Superparamagnetic iron nanoparticles perform comparably to radioisotope, but detect more sentinel lymph nodes and have a higher rate of detection of metastatic sentinel lymph nodes.

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Section: Discussionmentioning

confidence: 99%

Magnetically guided surgery after primary systemic therapy for breast cancer: implications for enhanced axillary mapping

Pantiora,

Eriksson,

Wärnberg

et al. 2024

British Journal of Surgery

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Current use and future perspectives of contrast-enhanced mammography (CEM): a survey by the European Society of Breast Imaging (EUSOBI)

Schiaffino,

Cozzi,

Clauser

et al. 2024

Eur Radiol

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Reliability of Magseed® marking before neoadjuvant systemic therapy with subsequent contrast-enhanced mammography in patients with non-palpable breast cancer lesions after treatment: the MAGMA study

Bravo,

Martínez,

Alvà

et al. 2024

Breast Cancer Res Treat

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Purpose To assess the reliability of excising residual breast cancer lesions after neoadjuvant systemic therapy (NAST) using a previously localized paramagnetic seed (Magseed®) and the subsequent use of contrast-enhanced spectral mammography (CESM) to evaluate response. Methods Observational, prospective, multicenter study including adult women (> 18 years) with invasive breast carcinoma undergoing NAST between January 2022 and February 2023 with non-palpable tumor lesions at surgery. Radiologists marked tumors with Magseed® during biopsy before NAST, and surgeons excised tumors guided by the Sentimag® magnetometer. CESMs were performed before and after NAST to evaluate tumor response (Response Evaluation Criteria for Solid Tumors [RECIST]). We considered intraoperative, surgical, and CESM-related variables and histological response. Results We analyzed 109 patients (median [IQR] age of 55.0 [46.0, 65.0] years). Magseed® was retrieved from breast tumors in all surgeries (100%; 95% CI 95.47–100.0%) with no displacement and was identified by radiology in 106 patients (97.24%), a median (IQR) of 176.5 (150.0, 216.3) days after marking. Most surgeries (94.49%) were conservative; they lasted a median (IQR) of 22.5 (14.75, 40.0) min (95% CI 23.59–30.11 min). Most dissected tumor margins (93.57%) were negative, and few patients (5.51%) needed reintervention. Magseed® was identified using CESM in all patients (100%); RECIST responses correlated with histopathological evaluations of dissected tumors using the Miller–Payne response grade (p < 0.0001) and residual lesion diameter (p < 0.0001). Also 69 patients (63.3%) answered a patient’s satisfaction survey and 98.8% of them felt very satisfied with the entire procedure. Conclusion Long-term marking of breast cancer lesions with Magseed® is a reliable and feasible method in patients undergoing NAST and may be used with subsequent CESM.

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Head-to-head comparison of contrast-enhanced mammography and contrast-enhanced MRI for assessing pathological complete response to neoadjuvant therapy in patients with breast cancer: a meta-analysis

Cited by 9 publications

References 35 publications

Magnetically guided surgery after primary systemic therapy for breast cancer: implications for enhanced axillary mapping

Magnetically guided surgery after primary systemic therapy for breast cancer: implications for enhanced axillary mapping

Current use and future perspectives of contrast-enhanced mammography (CEM): a survey by the European Society of Breast Imaging (EUSOBI)

Reliability of Magseed® marking before neoadjuvant systemic therapy with subsequent contrast-enhanced mammography in patients with non-palpable breast cancer lesions after treatment: the MAGMA study

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