scholarly journals Does contrast-enhanced mammography have an impact on the detection of cancer in patients with risk of developing breast cancer?

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Lamiaa Mohamed Bassam Hashem ◽  
Nancy Osama Abd El Hamid ◽  
Rasha Mohamed Kamal ◽  
Sahar Mahmoud Mansour ◽  
Shaimaa Lasheen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Precancerous Lesions ◽  
Imaging Modality ◽  
Positive Family History ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced ◽  
Increased Risk ◽  
History Of

Abstract Background Contrast-enhanced mammography (CEM) has been discovered to be more sensitive and specific than two-dimensional full-field digital mammography (FFDM) in both screening and diagnostic settings. The aim of the study was to assess the additive role of CEM in the detection and characterization of breast lesions in women with increased risk of developing breast cancer. This prospective study included 283 female patients with increased risk of developing breast cancer (i.e., positive family history of breast cancer, personal history of breast cancer, and heterogeneously dense mammary parenchyma) coming for either screening (n = 127/283 (49.1%)) or diagnostic (n = 156/283 (55.1%)) purpose. All patients had FFDM and CEM done, and the findings were evaluated independently; final Breast Imaging Reporting And Data System (BIRADS) classification was given for each modality. Results were then compared with histopathology or ultrasound findings with routine follow-up for normal and typically benign findings. Results In this study, 283 women with mean age of 48 were enrolled. Among the studied cases regardless to a specific risk factor, 15/283 (5.3%) were diagnosed as normal, 13/283 (4.6%) as inflammatory lesions, 72/283(25.4%) as benign lesions, 6/283 (2.1%) as benign precancerous lesions, and 177/283 (62.5%) as malignant. The overall sensitivity and specificity of the CEM were 92.7 and 71.43 %, respectively, while FFDM were 80.90 and 59.05%, respectively. Conclusion Contrast-enhanced mammography is a valuable screening and diagnostic imaging modality in patients with increased risk of developing breast cancer with diagnostic indices higher than mammography resulting in a significantly higher cancer detection rate.

scholarly journals Positive molecular breast imaging: challenges and problem solving with contrast-enhanced spectral mammography

2019 ◽  
Vol 12 (10) ◽  
pp. e230043
Author(s):  
Jeremy SL Ong ◽  
Felicity Whitewood ◽  
Donna B Taylor ◽  
Deepthi Dissanayake
Keyword(s):  
Problem Solving ◽  
Breast Imaging ◽  
Cross Correlation ◽  
High Sensitivity ◽  
Full Field ◽  
Molecular Breast Imaging ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced ◽  
Hypervascular Lesion ◽  
Anatomical Information

Molecular breast imaging (MBI) is a relatively new technique with high sensitivity for breast cancer detection. However, because it only provides limited anatomical information, cross-correlation of MBI findings with conventional breast imaging modalities such as full field digital mammography can be challenging. We report a case of a positive MBI study in a supplemental screening setting, where cross-correlation of MBI, ultrasound, mammogram and biopsy findings was difficult. Contrast-enhanced spectral mammography (CESM) demonstrated a hypervascular lesion at the biopsy clip, helping to prove imaging/histopathological concordance. This case highlights the challenges of incorporating MBI into conventional imaging workup, as well as the use of CESM in problem solving.

Abstract 12688: Long Term Use of Calcium Channel Blockers and Risk of Breast Cancer Development

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Uyen T Lam ◽  
Stacey Knight ◽  
Tami L Bair ◽  
Viet T Le ◽  
Joseph B Muhlestein ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Positive Family History ◽  
Channel Blockers ◽  
Increased Risk ◽  
History Of ◽  
Incident Breast Cancer

Introduction: Calcium channel blockers (CCBs) are a mainstay in treating hypertension (HTN). Recently, Li et-al published a population based case-control study (JAMA 2013; 289:2354) reporting CCB use to be associated with incident breast cancer (odds ratio 2.6). We prospectively analyzed 2 Intermountain Healthcare (IHC) databases (db) to confirm or refute this provocative report. Methods: Two separate analyses were conducted using general patients (GP) seen at IHC and patients undergoing coronary angiography (CV) at IHC facilities. Subjects were females aged 50-70 with no history of breast cancer. Those prescribed CCB were matched 1:1 to subjects not on CCB based on age, race, tobacco, alcohol, body mass index, HTN and follow up time. Multivariable Cox proportional hazards regression was used for the primary analysis of time to incident breast cancer by CCB use adjusting for history of other cancers and family history of breast cancer. Results: A total of 2612 GP subjects (cases/controls) and 1106 CV subjects (cases/controls) were studied. In the GP db, there was a statistically significant increased risk of breast cancer for subjects using CCB (HR=1.58; 95% CI: 1.10-2.26). Risk was also associated with a positive family history (HR=2.79; 1.96-3.97) and a personal history of cancer (HR=1.87; 1.07-3.26). Breast cancer predominantly developed in <5 y of follow up (64% of cases). However, a reverse relationship was found in the CV db, where the HR was 0.51 (95% CI: 0.27-0.97). This observation was found despite consistent associations with several secondary outcomes, including for incident diabetes, coronary and renal disease. Conclusion: A modest association between CCB use and incident breast cancer was observed in the GP db, but results were not reproducible in the CV db. Given lack of a credible mechanism and failure of previous randomized CCB studies to detect a signal, we interpret these modest and conflicting associations to likely represent uncorrected confounding, e.g. prescriber bias or drug interactions. Similarly, we believe the results of Li et-al may represent confounding. Given the important role of CCBs in clinical medicine, further studies are warranted, including randomized trials to assess CCB safety with respect to breast cancer risk.

scholarly journals Contrast-Enhanced Mammography for Screening Women after Breast Conserving Surgery

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3495
Author(s):  
Jill Gluskin ◽  
Carolina Rossi Saccarelli ◽  
Daly Avendano ◽  
Maria Adele Marino ◽  
Almir G. V. Bitencourt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conserving Surgery ◽  
Low Energy ◽  
Breast Cancer Patients ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Institutional Review ◽  
Asymptomatic Patients ◽  
Contrast Enhanced ◽  
One Year

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.

scholarly journals Current Status of Contrast Enhanced Mammography: A Comprehensive Review

2021 ◽  
pp. 084653712110290
Author(s):  
Anat Kornecki
Keyword(s):  
Breast Imaging ◽  
Dual Energy ◽  
Current Status ◽  
Resonance Imaging ◽  
Comprehensive Review ◽  
Full Field ◽  
Dce Mri ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced ◽  
Diagnostic Setting

Objectives: The purpose of this article is to provide a detailed and updated review of the physics, techniques, indications, limitations, reporting, implementation and management of contrast enhanced mammography. Background: Contrast enhanced mammography (CEM), is an emerging iodine-based modified dual energy mammography technique. In addition to having the same advantages as standard full-field digital mammography (FFDM), CEM provides information regarding tumor enhancement, relying on tumor angiogenesis, similar to dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). This article reviews current literature on CEM and highlights considerations that are critical to the successful use of this modality. Conclusion: Multiple studies point to the advantage of using CEM in the diagnostic setting of breast imaging, which approaches that of DCE-MRI.

Roles of Radiotherapy and Chemotherapy in the Development of Contralateral Breast Cancer

2008 ◽  
Vol 26 (34) ◽  
pp. 5561-5568 ◽  
Author(s):  
Maartje J. Hooning ◽  
Berthe M.P. Aleman ◽  
Michael Hauptmann ◽  
Margreet H.A. Baaijens ◽  
Jan G.M. Klijn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Adjuvant Chemotherapy ◽  
Contralateral Breast Cancer ◽  
Positive Family History ◽  
Young Patients ◽  
Contralateral Breast ◽  
Postmastectomy Radiotherapy ◽  
Increased Risk ◽  
History Of

Purpose Few studies have examined whether modern radiotherapy and chemotherapy affect the risk of contralateral breast cancer (CBC), and results are inconclusive. Patients and Methods We assessed long-term risk of CBC in a predominantly young breast cancer (BC) population (n = 7,221), focusing on the effects of radiation dose, chemotherapy, and family history of BC. Risk of CBC was evaluated using Cox proportional hazards regression models. Results Radiotherapy-associated risk of CBC increased with decreasing age at first treatment (age < 35 years, hazard ratio [HR] = 1.78; 95% CI, 0.85 to 3.72; age > 45 years, HR = 1.09; 95% CI, 0.82 to 1.45). Postmastectomy radiotherapy using direct electron fields led to a significantly lower radiation exposure to the contralateral breast than postlumpectomy radiotherapy using tangential fields. Women treated before age 45 years with postlumpectomy radiotherapy experienced 1.5-fold increased risk of CBC compared with those who had postmastectomy radiotherapy. The joint effects of postlumpectomy radiotherapy and strong family history for BC on risk of CBC were greater than expected when individual risks were summed (HR = 3.52; 95% CI, 2.07 to 6.02; Pdeparture from additivity = .043). Treatment with adjuvant chemotherapy (cyclophosphamide, methotrexate, and fluorouracil) was associated with a nonsignificantly decreased risk of CBC in the first 5 years of follow-up but did not reduce CBC risk in subsequent years. Conclusion Young patients with BC irradiated with breast tangentials experience increased risk of CBC, especially in those with a positive family history of BC. This finding should be taken into account when advising breast radiation with tangential fields to young patients with BC. Adjuvant chemotherapy seemed to reduce the risk of CBC during the first 5 years after treatment only.

scholarly journals Added value of contrast-enhanced spectral mammography in symptomatic patients with dense breasts

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Sara Ahmed Sadek Mohamed ◽  
Sherine George Moftah ◽  
Nivine Abd El Moneim Chalabi ◽  
Mona Ali Abdel-Wahed Salem
Keyword(s):  
Breast Cancer ◽  
Digital Mammography ◽  
Predictive Value ◽  
Treatment Plan ◽  
Added Value ◽  
Full Field ◽  
Dense Breasts ◽  
Full Field Digital Mammography ◽  
Appropriate Treatment ◽  
Contrast Enhanced

Abstract Background Breast cancer is the most common malignancy in females around the world representing 25.1% of all cancers. The high prevalence and need for early treatment of breast malignancy highlight the importance of early and accurate diagnosis. In order to achieve this target, it is necessary to select the most appropriate modality for investigation. Early detection of breast cancer by conventional mammography tends to reduce mortality; however, it has a low sensitivity and specificity in young females with dense breasts owing to reduced contrast between a possible tumor and the surrounding breast tissue with superimposition of the glandular tissue obscuring underlying lesions. Our study included 25 patients with dense breasts presented with different breast symptoms, yet the breast lump was the most common complaint. The aim of our study is to evaluate the supplementary value of contrast-enhanced spectral mammography in the assessment of symptomatic patients with dense breasts. Results In our study, the enrolled subjects underwent both contrast-enhanced spectral mammography (CESM) and conventional full-field digital mammography (FFDM). CESM was shown to be better than FFDM in terms of sensitivity, positive predictive value, negative predictive value, and accuracy, measuring 100%, 77.8%, 100%, and 84%, compared to 56%, 75%, 46%, and 60%, respectively, yet both modalities showed low specificity, measuring 63.6% and 66.6% for CESM and FFDM, respectively. The added value of CESM was assessed in terms of ability to detect and correctly characterize the lesions in correlation to histopathological results where CESM could detect 88% of the lesions included in our study and correctly characterized 84% of the lesions; on the other side, FFDM detected only 20% of the lesions and correctly characterized 60% of the lesions. CESM changed the treatment plan to a more extensive surgery +/− neoadjuvant chemotherapy in 57% out of fourteen cases diagnosed with breast cancer emphasizing the role of CESM in assessing the extent of the disease, multicentricity, and multifocality and consequently tailoring the most appropriate treatment plan suitable for each patient. Conclusion Contrast-enhanced spectral mammography is superior to full-field digital mammography in patients with dense breasts with a significant supplementary value in detection, characterization of lesions, and tailoring the appropriate treatment plan.

scholarly journals Initial Experience with Combination Digital Breast Tomosynthesis Plus Full Field Digital Mammography or Full Field Digital Mammography Alone in the Screening Environment

2014 ◽  
Vol 4 ◽  
pp. 9 ◽  
Author(s):  
Stamatia Destounis ◽  
Andrea Arieno ◽  
Renee Morgan
Keyword(s):  
Breast Cancer ◽  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Screening Mammography ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Significant Difference ◽  
History Of

Objectives: Initial review of patients undergoing screening mammography imaged with a combination of digital breast tomosynthesis (DBT) plus full field digital mammography (FFDM) compared with FFDM alone. Materials and Methods: From June 2011 to December 2011, all patients presenting for routine screening mammography were offered a combination DBT plus FFDM exam. Under institutional review board approval, we reviewed 524 patients who opted for combination DBT plus FFDM and selected a sample group of 524 FFDM screening exams from the same time period for a comparative analysis. The χ2 (Chi-square) test was used to compare recall rates, breast density, personal history of breast cancer, and family history of breast cancer between the two groups. Results: Recall rate for FFDM, 11.45%, was significantly higher (P < 0001) than in the combination DBT plus FFDM group (4.20%). The biopsy rate in the FFDM group was 2.29% (12/524), with a cancer detection rate of 0.38% (2/524, or 3.8 per 1000) and positive predictive value (PPV) of 16.7% (2/12). The biopsy rate for the DBT plus FFDM group was 1.14% (n = 6/524), with a cancer detection rate 0.57% (n = 3/524, or 5.7 per 1000) and PPV of 50.0% (n = 3/6). Personal history of breast cancer in the FFDM group was significantly lower (P < 0.0001) than in the combination DBT plus FFDM group; 2.5% and 5.7%, respectively. A significant difference in family history of breast cancer (P < 0.0001) was found, with a higher rate in the combination DBT plus FFDM group (36.0% vs. 53.8%). There was a significant difference between the combination DBT plus FFDM group and FFDM alone group, when comparing breast density (P < 0.0147, 61.64% vs. 54.20% dense breasts, respectively) with a higher rate of dense breasts in the DBT plus FFDM group. In follow-up, one cancer was detected within one year of normal screening mammogram in the combination DBT plus FFDM group. Conclusion: Our initial experience found the recall rate in the combination DBT plus FFDM group was significantly lower than in the FFDM alone group, despite the fact that the combination DBT plus FFDM group had additional risk factors.

DETECTION OF BREAST CANCERS REPRESENTED AS ARCHITECTURAL DISTORTION: A COMPARISON OF FULL-FIELD DIGITAL MAMMOGRAPHY AND DIGITAL BREAST TOMOSYNTHESIS

2021 ◽  
Vol 74 (7) ◽  
pp. 1674-1679
Author(s):  
Tetiana M. Babkina ◽  
Andrii V. Gurando ◽  
Tetiana M. Kozarenko ◽  
Viacheslav R. Gurando ◽  
Vadim V. Telniy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Architectural Distortion ◽  
Breast Cancers ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Ductal Hyperplasia ◽  
History Of

The aim: The aim of our study was to determine if digital breast tomosynthesis improves breast cancer detection associated with architectural distortion in comparison with full-field digital mammography in the absence of appropriate history of trauma or surgery. Materials and methods: The overall rate of breast cancer involvement for the 34 patients with architectural distortion was 15 cases (44,1%) (invasive breast cancers, n=12 (36,4%); ductal cancer in situ, n= 3 (8,8%)) other findings associated with architectural distortion were high-risk lesions and benign findings (radial scar, n=5 (14,7%); sclerosing adenosis, n=9 (26,5%); typical lobular hyperplasia, n=3 (8,8%); typical ductal hyperplasia, n=2 cases (5,9%)). Results: Overall of 17/34 (50.0%) architectural distortions were identified at digital breast tomosynthesis that were missed at full-field digital mammography what was statistically significant difference ([95% CI, 2.56–7.45]; p=0.00001). Analysis of the results showed that sensitivity of full-field digital mammography for digital breast tomosynthesis detected breast cancers associated with architectural distortion was 53.3% [95% CI, 26.59% to 78.73%] and specificity was 52.63% [95% CI, 28.86% to 75.55%]. Conclusions: Our study suggests that digital breast tomosynthesis detects more breast cancers represented as architectural distortion which are occult on full-field digital mammography. Presence of microcalcifications within architectural distortion, in the absence of appropriate history of trauma or surgery, has a high likelihood of malignancy and obligatorily requires biopsy.

scholarly journals A Case Report of Germline Compound Heterozygous Mutations in the BRCA1 Gene of an Ovarian and Breast Cancer Patient

2021 ◽  
Vol 22 (2) ◽  
pp. 889
Author(s):  
Ava Kwong ◽  
Cecilia Y. S. Ho ◽  
Vivian Y. Shin ◽  
Chun Hang Au ◽  
Tsun Leung Chan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Brca1 Gene ◽  
Pathogenic Mutation ◽  
Compound Heterozygous ◽  
Strong Family History ◽  
Breast And Ovarian Cancer ◽  
Pathogenic Mutations ◽  
Increased Risk ◽  
History Of

The germline carrier of the BRCA1 pathogenic mutation has been well proven to confer an increased risk of breast and ovarian cancer. Despite BRCA1 biallelic pathogenic mutations being extremely rare, they have been reported to be embryonically lethal or to cause Fanconi anemia (FA). Here we describe a patient who was a 48-year-old female identified with biallelic pathogenic mutations of the BRCA1 gene, with no or very subtle FA-features. She was diagnosed with ovarian cancer and breast cancer at the ages of 43 and 44 and had a strong family history of breast and gynecological cancers.

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