Role of Contrast Enhanced Mammography in Cases Presented with Primary Breast Edema

Abstract

Background: Breast edema in inflammatory breast cancer can cause tremendous skin thickening and breast enlargement that attenuates both the xray and ultrasound beams because of the enlarged, dense breast tissue filled with fluid and tumor. Objective: was to evaluate the value of Contrast-enhanced digital mammography in the assessment of breast lesions in the edematous breast. Patients & Methods: A prospective study conducted on 55 female patients presented with primary breast edema. Mammography followed by contrast mammography was done for all cases. Data were analyzed. Statistical tests were performed to check for sensitivity, specificity, accuracy and predictive values for both modalities. Results: Contrast-enhanced digital mammography was more sensitive and specific in the detection of lesions and better assessment of the local extent of the disease in cases with edematous breast changes. It was accurate in the detection of multifocal/multi-centric disease, being a good positive test in the delineation of masses obscured by condensed parenchymal tissue. The calculated sensitivity of digital mammography & Contrast-enhanced digital mammography was 87.5 %, 95.8%, specificity was 55.5%, 88.8%. The PPV and NPV were 91, 97.9 % and 45%, 80 % respectively. Conclusion: Contrast-enhanced digital mammography is a promising and affordable technique in the assessment of suspicious lesions in mammographically dense breast especially in primary edematous breast cases.