The role of contrast-enhanced spectral mammography in the evaluation of the postoperative breast cancer

Helal, M. A.; Mansour, Sahar; Ahmed, H.A.; Ghany, Ahmed Fathy Abdel; Kamel, Omar Farouk; Elkholy, Nehal

doi:10.1016/j.crad.2019.06.002

Cited by 21 publications

(7 citation statements)

References 17 publications

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“…There is little data assessing the role of CEM in cancer detection in the posttreatment breast. Helal et al [51] found CEM improved the performance of FFDM with higher sensitivity, specificity, PPV, and NPV. False-positive findings on CEM were mostly due to enhancing fat necrosis.…”

Section: Evaluation Of the Posttreatment Breastmentioning

confidence: 99%

Contrast-enhanced mammography: past, present, and future

et al. 2021

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Section: Evaluation Of the Posttreatment Breastmentioning

confidence: 99%

Contrast-enhanced mammography: past, present, and future

et al. 2021

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“…CEM has consistently shown improved sensitivity compared with FFDM, particularly in women with dense breasts [25,[41][42][43][44][45][46]. A recent publication including 76 women with a history of BCS showed an improved sensitivity of CEM compared with FFDM in the detection of recurrences [47].…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Mammography for Screening Women after Breast Conserving Surgery

Gluskin

Saccarelli

Avendaño

et al. 2020

Cancers

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To investigate the value of contrast-enhanced mammography (CEM) compared to full-field digital mammography (FFDM) in screening breast cancer patients after breast-conserving surgery (BCS), this Health Insurance Portability and Accountability Act-compliant, institutional review board-approved retrospective, single-institution study included 971 CEM exams in 541 asymptomatic patients treated with BCS who underwent screening CEM between January 2013 and November 2018. Histopathology, or at least a one-year follow-up, was used as the standard of reference. Twenty-one of 541 patients (3.9%) were diagnosed with ipsi- or contralateral breast cancer: six (28.6%) cancers were seen with low-energy images (equivalent to FFDM), an additional nine (42.9%) cancers were detected only on iodine (contrast-enhanced) images, and six interval cancers were identified within 365 days of a negative screening CEM. Of the 10 ipsilateral cancers detected on CEM, four were detected on low-energy images (40%). Of the five contralateral cancers detected on CEM, two were detected on low-energy images (40%). Overall, the cancer detection rate (CDR) for CEM was 15.4/1000 (15/971), and the positive predictive value (PPV3) of the biopsies performed was 42.9% (15/35). For findings seen on low-energy images, with or without contrast, the CDR was 6.2/1000 (6/971), and the PPV3 of the biopsies performed was 37.5% (6/16). In the post-BCS screening setting, CEM has a higher CDR than FFDM.

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“…Immediate assessment of the treated breast after surgery for the presence of residual disease is often challenging because of the resultant inflammatory changes, operative bed seroma/hematoma, and scarring distortion, all of which may mimic residual malignancy [59,60]. Although the role of CEM was assessed in some studies for the postoperative breast, its use in the immediate postoperative period has not yet been validated [61]. MRI has the ability to differentiate inflammatory collections and edema from residual malignancy [62].…”

Section: *Follow Up Of the Treated Breastmentioning

confidence: 99%

“…Few studies have been performed to test the validity to use CEM instead of MRI in the assessment of the symptomatic cases of breast cancer after surgery [61,64] (Fig. 8a, b).…”

Section: *Follow Up Of the Treated Breastmentioning

confidence: 99%

“…8a, b). Helal et al [61] concluded that CEM is a credible technique that could be used in conjunction with the traditional mammogram to screen for cancer in the breast cancer patients which have been treated with surgery. However, sometimes the performance of the CEM is limited due to the inability to assess the mastectomy bed and the axillary node recurrence.…”

Section: *Follow Up Of the Treated Breastmentioning

confidence: 99%

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Contrast-enhanced mammography in comparison with dynamic contrast-enhanced MRI: which modality is appropriate for whom?

Kamal

Mansour

Farouk

et al. 2021

Egypt J Radiol Nucl Med

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Background Dynamic contrast-enhanced MRI (DCE-MRI) is a revolution regarding screening and diagnosis of breast cancer. Yet, sometimes it is not the appropriate choice of imaging since the examination needs to be scheduled and may take place in another department. Contrast-enhanced mammography (CEM) is contrast-based digital mammogram, and consequently, it has emerged as a potential and promising replacer to DCE-MRI. Main body of the abstract There is a frequently asked question during the multidisciplinary breast cancer tumor boards is: which modality is more appropriate to be used in each clinical scenario? This article provided a detailed understanding of these two modalities in order to achieve a successful implementation of them into the clinical practice. Which modality to start with, in the context of the detection (screening) followed by characterization or diagnosis of the identified lesions? What is the appropriate application of both modalities in local staging and follow-up? All of these issues would be discussed in this article. Short conclusion MRI is a safe tool for breast imaging and has a superior diagnostic performance compared to CEM. However, CEM is getting close: this lies in its accessibility, short-time procedure, requirement of less training and feasibility to standardize.

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The role of contrast-enhanced spectral mammography in the evaluation of the postoperative breast cancer

Cited by 21 publications

References 17 publications

Contrast-enhanced mammography: past, present, and future

Contrast-enhanced mammography: past, present, and future

Contrast-Enhanced Mammography for Screening Women after Breast Conserving Surgery

Contrast-enhanced mammography in comparison with dynamic contrast-enhanced MRI: which modality is appropriate for whom?

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