Added value of contrast-enhanced mammography (CEM) in staging of malignant breast lesions—a feasibility study

Autor: Sophia Zackrisson, Anna Gardfjell, Kristina Åhsberg, Catharina Behmer, Lisa Rydén, Emma Niméus, Rogvi W Rasmussen
Jazyk: angličtina
Rok vydání: 2020
Předmět:
medicine.medical_treatment
Biopsy
Contrast Media
030218 nuclear medicine & medical imaging
law.invention
0302 clinical medicine
Breast cancer
Randomized controlled trial
law
Clinical endpoint
Breast
Mastectomy
Aged
80 and over
medicine.diagnostic_test
CEM
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Oncology
CESM
030220 oncology & carcinogenesis
Female
Preoperative staging
Radiology
Mammography
Adult
medicine.medical_specialty
Digital mammography
lcsh:Surgery
Breast Neoplasms
Sensitivity and Specificity
lcsh:RC254-282
03 medical and health sciences
Preoperative Care
medicine
Humans
Adverse effect
Aged
Neoplasm Staging
business.industry
Research
Contrast-enhanced mammography
Contrast-enhanced spectral mammography
lcsh:RD1-811
medicine.disease
Feasibility Studies
Surgery
Histopathology
business
Zdroj: World Journal of Surgical Oncology, Vol 18, Iss 1, Pp 1-9 (2020)
World Journal of Surgical Oncology
ISSN: 1477-7819
Popis: Objectives The aim of this feasibility study was to evaluate the added value of contrast-enhanced mammography (CEM) in preoperative staging of malignant breast lesions, beyond standard assessment with digital mammography and ultrasound, as a base for a future prospective randomized trial. Materials and methods Forty-seven patients, with confirmed or strongly suspected malignant breast lesions after standard assessment (digital mammography (DM) and ultrasound (US)), scheduled for primary surgery, were invited to undergo CEM as an additional preoperative procedure. The primary endpoint was change in treatment due to CEM findings, defined as mastectomy instead of partial mastectomy or contrariwise, bilateral surgery instead of unilateral or neoadjuvant treatment instead of primary surgery. Accuracy in tumour extent estimation compared to histopathology was evaluated by Bland-Altman statistics. Number of extra biopsies and adverse events were recorded. Results In 10/47 patients (21%), findings from CEM affected the primary treatment. Agreement with histopathology regarding extent estimation was better for CEM (mean difference − 1.36, SD ± 18.45) in comparison with DM (− 4.18, SD ± 26.20) and US (− 8.36, SD ± 24.30). Additional biopsies were taken from 19 lesions in 13 patients. Nine biopsies showed malignant outcome. No major adverse events occurred. Conclusion The feasibility of preoperative additional CEM was found to be satisfactory without any serious negative effects. Results imply an added value of CEM in preoperative staging of breast cancer. Further evaluation in larger prospective randomized trials is needed. Trial registration ClinicalTrials.gov, NCT03402529. Registered 18 January 2018—retrospectively registered
Databáze: OpenAIRE
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