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 The Diagnostic Value of Contrast-enhanced 2D Mammography in Everyday Clinical use

2021 ◽  
Author(s):  
Lidewij Neeter ◽  
Frank Raat ◽  
Stephanie Meens-Koreman ◽  
Rogier van Stiphout ◽  
Steffie Timmermans ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Diagnostic Value ◽  
Low Energy ◽  
Response Monitoring ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced ◽  
One Year ◽  
Histopathological Results

Abstract Contrast-enhanced mammography (CEM) has shown to be superior to full-field digital mammography (FFDM), but current results are dominated by studies performed on systems by one vendor. Information on diagnostic accuracy of other CEM systems is limited. Therefore, we aimed to evaluate the diagnostic performance of CEM on an alternative vendor’s system.We included all patients who underwent CEM in one hospital in 2019, except those with missing data or in whom CEM was used as response monitoring tool. Three experienced breast radiologists scored the low-energy images using the BI-RADS classification. Next, the complete CEM exams were scored similarly. Histopathological results or a minimum of one year follow-up were used as reference standard. Diagnostic performance and AUC were calculated and compared between low-energy images and the complete CEM examination , for all readers independently as well as combined. Breast cancer was diagnosed in 23% of the patients (35/152). Compared to low-energy images, overall CEM sensitivity increased from 74.3% to 87.6% (p<0.0001), specificity from 87.8% to 94.6% (p=0.0146). AUC increased from 0.872 to 0.957 (p=0.0001). Performing CEM on the system tested, showed that, similar to earlier studies mainly performed on another vendor’s systems, both sensitivity and specificity improved when compared to FFDM.

scholarly journals The diagnostic value of contrast-enhanced 2D mammography in everyday clinical use

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. M. F. H. Neeter ◽  
H. P. J. Raat ◽  
S. D. Meens-Koreman ◽  
R. S. A. van Stiphout ◽  
S. M. E. C. Timmermans ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Diagnostic Value ◽  
Low Energy ◽  
Response Monitoring ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced ◽  
One Year ◽  
Histopathological Results

AbstractContrast-enhanced mammography (CEM) has shown to be superior to full-field digital mammography (FFDM), but current results are dominated by studies performed on systems by one vendor. Information on diagnostic accuracy of other CEM systems is limited. Therefore, we aimed to evaluate the diagnostic performance of CEM on an alternative vendor’s system. We included all patients who underwent CEM in one hospital in 2019, except those with missing data or in whom CEM was used as response monitoring tool. Three experienced breast radiologists scored the low-energy images using the BI-RADS classification. Next, the complete CEM exams were scored similarly. Histopathological results or a minimum of one year follow-up were used as reference standard. Diagnostic performance and AUC were calculated and compared between low-energy images and the complete CEM examination, for all readers independently as well as combined. Breast cancer was diagnosed in 23.0% of the patients (35/152). Compared to low-energy images, overall CEM sensitivity increased from 74.3 to 87.6% (p < 0.0001), specificity from 87.8 to 94.6% (p = 0.0146). AUC increased from 0.872 to 0.957 (p = 0.0001). Performing CEM on the system tested, showed that, similar to earlier studies mainly performed on another vendor’s systems, both sensitivity and specificity improved when compared to FFDM.

Method of detection of local recurrence in patients following breast conserving surgery and its utility for surveillance

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 611-611
Author(s):  
B. Taback ◽  
N. Hansen ◽  
K. Conway ◽  
A. Giuliano
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Cancer Patients ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Conclusive Evidence ◽  
Breast Cancer Patients ◽  
Asymptomatic Patients

611 Background: It is estimated that approximately 10% of all breast cancer patients will develop local recurrence (LR) at 10 years. Routine surveillance for detection of early breast cancer recurrence is widely performed despite lack of conclusive evidence for an improvement in patient quality of life or potential for cure. A number of historical studies evaluating the effectiveness of routine screening for LR following treatment for early-stage breast cancer have suggested that the diagnosis of LR is more frequent during a routine visit and occurring in asymptomatic patients. However, differentiating the method of detection is not often elucidated. In this study we evaluated the manner in which patients presented with an isolated LR in clinical practice. Methods: Our routine patient follow-up consists of physical exam and mammogram every 6 mos for the first 2 years following breast conserving surgery (BCS) and yearly thereafter. We queried our prospectively collected breast cancer database (1632 patients from July 1986 - July 2004) for patients with an isolated LR following BCS (n=59 (3.6%); two patients had bilateral LRs). Medical records were not available for three patients. Results: At a median follow-up of 45 mos (range: 5–122 mos) there were 58 evaluable LRs: 15 DCIS, 31 infiltrating ductal carcinoma (IDC), 6 infiltrating lobular (ILC), 2 mixed IDC/ILC, 3 invasive cancers NOS and 1 unknown. Patient presentation was as follows: 25 were diagnosed by self-exam, 28 on screening mammogram, 2 were diagnosed by physician (includes one referral), and 3 unknown. Mammogram detected recurrences were more frequent among patients with DCIS whereas self-detected recurrences were more common in patients with IDC (79% vs 33% and 21% vs 67%, respectively; P<0.2). Mean tumor size was larger in self-presentation (2.1 cm; range: 0.8–4.5 cm) than in mammogram detected group (1.6 cm; range 0.4–6 cm). Conclusions: These findings demonstrate the value of mammography as compared to patient detected LRs. Whether a survival advantage exists remains uncertain. Nevertheless routine physician examination in this setting is highly insensitive and its further utility must be considered when devising cost-effective strategies for surveillance of breast cancer patients. No significant financial relationships to disclose.

Low energy mammogram obtained in contrast-enhanced digital mammography (CEDM) is comparable to routine full-field digital mammography (FFDM)

2014 ◽  
Vol 83 (8) ◽  
pp. 1350-1355 ◽  
Author(s):  
Mark A. Francescone ◽  
Maxine S. Jochelson ◽  
D. David Dershaw ◽  
Janice S. Sung ◽  
Mary C. Hughes ◽  
...  
Keyword(s):  
Digital Mammography ◽  
Low Energy ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced

scholarly journals Diagnostic performance of digital breast tomosynthesis for predicting response to neoadjuvant systemic therapy in breast cancer patients: A comparison with magnetic resonance imaging, ultrasound, and full-field digital mammography

2021 ◽  
Vol 10 (12) ◽  
pp. 205846012110637
Author(s):  
Ryusuke Murakami ◽  
Hitomi Tani ◽  
Shinichiro Kumita ◽  
Nachiko Uchiyama
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Tumor Size ◽  
Digital Breast Tomosynthesis ◽  
Residual Tumor ◽  
Breast Cancer Patients ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Neoadjuvant Systemic Therapy

Background The goals of neoadjuvant systemic therapy (NST) are to reduce tumor volume and to provide a prognostic indicator in assessing treatment response. Digital breast tomosynthesis (DBT) was developed and has increased interest in clinical settings due to its higher sensitivity for breast cancer detection compared to full-field digital mammography (FFDM). Purpose To evaluate the accuracy of DBT in assessing response to NST compared to FFDM, ultrasound (US), and magnetic resonance imaging (MRI) in breast cancer patients. Material and Methods In this retrospective study, 95 stages II–III breast cancer patients undergoing NST and subsequent surgeries were enrolled. After NST, the longest diameter of residual tumor measured by DBT, FFDM, US, and MRI was compared with pathology. Agreements and correlations of tumor size were assessed, and the diagnostic performance for predicting pathologic complete response (pCR) was evaluated. Results Mean residual tumor size after NST was 19.9 mm for DBT, 18.7 mm for FFDM, 16.0 mm for US, and 18.4 mm for MRI, compared with 17.9 mm on pathology. DBT and MRI correlated better with pathology than that of FFDM and US. The ICC values were 0.85, 0.87, 0.74, and 0.77, respectively. Twenty-five patients (26.3%) achieved pCR after NST. For predicting pCR, area under the receiver operating characteristic (ROC) curve for DBT, FFDM, US, and MRI were 0.79, 0.66, 0.68, and 0.77, respectively. Conclusion DBT has good correlation with histopathology for measuring residual tumor size after NST. DBT was comparable to MRI in assessing tumor response after completion of NST.

scholarly journals Ultrasound surveillance on detection of nonpalpable supraclavicular recurrence after breast cancer surgery

2020 ◽  
Vol 22 (2) ◽  
pp. 171
Author(s):  
Eun Cho ◽  
Jin Hwa Lee ◽  
Eun Hwa Park ◽  
Kyung Do Byun
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Primary Breast Cancer ◽  
Multivariate Logistic Regression Analysis ◽  
Breast Conserving Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Asymptomatic Patients ◽  
Internal Mammary

Aims: To evaluate the clinical utility of supraclavicular scanning for locoregional lymph node (LN) assessment in postoperative screening surveillance using ultrasonography (US) in patients who underwent breast cancer surgery.Material and methods: From July 2004 to February 2019, 280 suspicious findings for locoregional recurrence in the lymph node (LRL) on postoperative screening US were detected in 266 asymptomatic patients who underwent breast cancer surgery. Suspicious features of LRL on US included the marked hypoechogenicity, round or irregular shape, eccentric cortical thickening and replacement of the fatty hilum of the LNs. The bilateral breasts, including mastectomy sites, bilateral axillae, internal mammary areas and supraclavicular areas, were included in the scan range of postoperative US.Results: Of 280 LNs with suspicious findings for LRL, LRL of supraclavicular LNs was confirmed in 24 LNs according to cytopathology results. Multivariate logistic regression analysis revealed that higher overall staging of primary breast cancer (odds ratio [OR] 2.361 [95% confidence interval (CI) 1.302–4.282]; p=0.005), higher N staging of primary breast cancer (OR 3.086 [95% CI 1.479–6.441]; p=0.003), older patient age (OR 1.060 [95% CI 1.026–1.095]; p<0.001) and breast-conserving surgery (OR 2.253 [95% CI 1.184–4.289]; p=0.013) were independently associated with LRL of supraclavicular LNs. Tumor size, nuclear grade, histological type, hormonal receptor status of the primary cancer, and bilateral cancer were not associated with LRL (p=0.216, p=0.205, p=0.789, p=0.899, and p=0.900, respectively).Conclusion: Routine supraclavicular scanning in postoperative screening surveillance using US in breast cancer patients with higher staging could be useful for the detection of LRL of supraclavicular LNs. 

scholarly journals Evaluation of low-energy contrast-enhanced spectral mammography images by comparing them to full-field digital mammography using EUREF image quality criteria

2015 ◽  
Vol 25 (10) ◽  
pp. 2813-2820 ◽  
Author(s):  
U. C. Lalji ◽  
C. R. L. P. N. Jeukens ◽  
I. Houben ◽  
P. J. Nelemans ◽  
R. E. van Engen ◽  
...  
Keyword(s):  
Image Quality ◽  
Digital Mammography ◽  
Quality Criteria ◽  
Low Energy ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced

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 Quantitative Assessment of Iodine Intensity of Different Types of Lesions in the Low-Energy (LE) Images of Contrast-Enhanced Spectral Mammography (CESM)

2021 ◽  
pp. 1-5
Author(s):  
Sachila Niroshani ◽  
Sachila Niroshani ◽  
Tokiko Nakamura ◽  
Nikaidou Michiru ◽  
Toru Negishi
Keyword(s):  
Iodine Concentration ◽  
Low Energy ◽  
Fatty Tissue ◽  
Full Field ◽  
Mean Intensity ◽  
Full Field Digital Mammography ◽  
Contrast Enhanced ◽  
Different Types ◽  
The One ◽  
Minimum Intensity

Purpose: To assess the iodine enhancement intensity of breast lesions in low energy (LE) images obtained in contrast-enhanced spectral mammography (CESM) with different tissue compositions. Materials and Methods: A 50 mm dedicated phantom with different lesion insert and iodine insert were used to assess the enhancement intensity quantitatively. The target slab of the phantom consists of three lesions + iodine inserts together and 100% adipose equivalent,100% glandular equivalent inserts alone to mimic the adipose and glandular lesion without contrast-enhancement. Each iodine inserts having a concentration of 0.5 mgI/cm3, 1.0 mgI/cm3, 2.0 mgI/cm3. The phantom was exposed under semiautomated function at 28 kV, 30 kV, and 32 kV with Mo/Rh target/filter combination. Iodine intensity was estimated for three types of lesions at three breast equivalent compositions. Results: Lesions with fatty tissue had high intensity while lesions with glandular tissues had the minimum intensity. Among fatty lesions, highest mean intensity value (0.972±0.003) observed with minimum iodine concentration (F + 0.5 mgI/cm3). The highest mean intensity value (0.882±0.001) was found related to the glandular lesion with maximum iodine concentration (G + 2.0 mgI/cm3). The one-way ANOVA statistical test confirmed that mean intensity values were significantly varied among different lesions (P < 0.05). Conclusion: LE images obtained in CESM can be used to identify the different types of lesions without performing the full field digital mammography (FFDM) as an additional examination prior to the CESM procedure.

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