scholarly journals Contrast-Enhanced Mammography (CEM) for Detecting Residual Disease after Neoadjuvant Chemotherapy: A Comparison with Breast Magnetic Resonance Imaging (MRI)

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Filipe Ramos Barra ◽  
Alaor Barra Sobrinho ◽  
Renato Ramos Barra ◽  
Mayra Teixeira Magalhães ◽  
Laira Rodrigues Aguiar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Size ◽  
Residual Disease ◽  
Pearson Correlation ◽  
Newly Diagnosed ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Magnetic Resonance Imaging Mri

Objective. To evaluate the performance of contrast-enhanced mammography (CEM) compared to magnetic resonance imaging (MRI) for estimating residual tumor size after neoadjuvant chemotherapy (NAC) in women with newly diagnosed breast cancer. Methods. The institutional review board approved this study. This prospective study included women with newly diagnosed breast cancer who underwent breast CEM and MRI at the end of the last cycle of NAC and before definitive surgery. Size of residual malignancy on post-NAC CEM and MRI was compared with surgical pathology. Agreements and correlations of CEM and MRI measurements with histological size were assessed. Results. Thirty-three patients were included with a mean age of 45 years (range 22–76). The sensitivity, specificity, and positive and negative predictive value for detection of residual disease of CEM were 76%, 87.5%, 95%, and 86.4%, and those of MRI were 92%, 75%, 92%, and 75%. Comparing CEM to MRI, the mean difference was −0.8 cm, concordance coefficient was 0.7, and Pearson correlation was 0.7 (p = 0.0003). The concordance coefficient between measurements of each imaging modality and pathologic tumor size was 0.7 for CEM and 0.4 for MRI. Pearson correlation was 0.8 for CEM and 0.5 for MRI. Mean differences between CEM, MRI, and residual histopathological tumor size were 0.8 cm and 1.8 cm, respectively. Conclusions. CEM has good correlation and agreement with histopathology for measuring residual disease after NAC. CEM was comparable to MRI, showing high positive predictive value and specificity for detecting residual disease.

scholarly journals Contrast-enhanced spectral mammography in the radiological assessment of response to neoadjuvant chemotherapy in breast cancer

2021 ◽  
pp. e521
Author(s):  
Anna Grażyńska ◽  
Sofija Antoniuk ◽  
Katarzyna Steinhof-Radwańska
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Neoadjuvant Chemotherapy ◽  
Residual Disease ◽  
Tumour Size ◽  
Breast Cancer Diagnosis ◽  
Chemotherapy Response ◽  
Resonance Imaging ◽  
Contrast Enhanced

Accurate morphological assessment and measurement of the residual disease following neoadjuvant chemotherapy are vital for the effective surgical treatment in patients with breast cancer. Neoadjuvant chemotherapy response is measured by RECIST 1.1 criteria (Response Evaluation Criteria in Solid Tumors), and the classification of the specific therapeutic responses is based on the difference in the tumour size prior to and after chemotherapy. There are currently a few methods of imaging used in the assessment of the neoadjuvant chemotherapy response. Conventional mammography remains the most popular method, whereas magnetic resonance imaging is considered the most effective ones. Nonetheless, the available methods tend to be imperfect and limited, and therefore, new methods are constantly investigated. Contrast-enhanced spectral mammography is a relatively new method used in breast cancer diagnosis, which involves the phenomenon of neoangiogenesis of cancerous tumours, allowing contrast enhancement in the areas of vessel proliferation in the background of the surrounding breast tissue. Contrast-enhanced spectral mammography presents sensitivity similar to magnetic resonance imaging in breast cancer detection, and can be an efficient method used in monitoring neoadjuvant chemotherapy response.

scholarly journals Multifocality and Multicentrality in Breast Cancer: Comparison of the Efficiency of Mammography, Contrast-Enhanced Spectral Mammography, and Magnetic Resonance Imaging in a Group of Patients with Primarily Operable Breast Cancer

2021 ◽  
Vol 28 (5) ◽  
pp. 4016-4030
Author(s):  
Katarzyna Steinhof-Radwańska ◽  
Andrzej Lorek ◽  
Michał Holecki ◽  
Anna Barczyk-Gutkowska ◽  
Anna Grażyńska ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Surgical Intervention ◽  
Histopathological Examination ◽  
Breast Conserving Therapy ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Highly Sensitive ◽  
Magnetic Resonance Imaging Mri

Background: The multifocality and multicentrality of breast cancer (MFMCC) are the significant aspects that determine a specialist’s choice between applying breast-conserving therapy (BCT) or performing a mastectomy. This study aimed to assess the usefulness of mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in women diagnosed with breast cancer before qualifying for surgical intervention to visualize other (additional) cancer foci. Methods: The study included 60 breast cancer cases out of 630 patients initially who underwent surgery due to breast cancer from January 2015 to April 2019. MG, CESM, and MRI were compared with each other in terms of the presence of MFMCC and assessed for compliance with the postoperative histopathological examination (HP). Results: Histopathological examination confirmed the presence of MFMCC in 33/60 (55%) patients. The sensitivity of MG in detecting MFMCC was 50%, and its specificity was 95.83%. For CESM, the sensitivity was 85.29%, and the specificity was 96.15%. For MRI, all the above-mentioned parameters were higher as follows: sensitivity—91.18%; specificity—92.31%. Conclusions: In patients with MFMCC, both CESM and MRI are highly sensitive in the detection of additional cancer foci. Both CESM and MRI change the extent of surgical intervention in every fourth patient.

Magnetic resonance imaging and ultrasound for prediction of residual tumor size in early breast cancer within the ADAPT subtrials

2020 ◽  
Author(s):  
Monika Graeser ◽  
Simone Schrading ◽  
Oleg Gluz ◽  
Kevin Strobel ◽  
Christopher Herzog ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Tumor Size ◽  
Residual Tumor ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Cancer Subtypes ◽  
Magnetic Resonance Imaging Mri ◽  
Imaging Performance

Abstract Background: Prediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes.Methods: Imaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance for prediction of tumor size was analyzed across increasing size ranges (≤10, ≤20 and ≤30 mm) and summarized using positive (PPV) and negative predictive values (NPV).Results: 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by <10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, PPV (correctly predicted tumor size ≤10, ≤20 or ≤30 mm) of MRI and ultrasound increased from 0.61 and 0.72 for ≤10 mm tumors to 0.88 and 0.96 for ≤30 mm tumors; NPV (correctly predicted tumor size >10, >20 or >30 mm) decreased from 0.89 and 0.74 to 0.69 and 0.22. Across all tumor size ranges, ultrasound demonstrated higher PPV than MRI in HR+/HER2+ tumors while both methods had a similarly low PPV in HR-/HER2- and HR-/HER2+ tumors. MRI had a higher NPV than ultrasound with the exception of HR-/HER2- tumors measuring ≤10 and ≤20 mm where both methods had similar NPV. Conclusions: Ultrasound is less likely than MRI to underestimate the size of HR+/HER2+ tumors while MRI is associated with a lower risk to overestimate the size of HR+/HER2+ and HR-/HER2+ tumors. These findings may help to select the most optimal imaging approach for planning surgery after NAT. Trial registration: Clinicaltrials.gov, NCT01815242 (registration March 21, 2013, NCT01817452 (registration March 25, 2013), NCT01779206 (registration January 30, 2013).

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