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 |
Externí odkaz: | |
Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |