Evaluation of contrast-enhanced digital mammography (CEDM) in the preoperative staging of breast cancer: Large-scale single-center experience
| Autor: | Giulia Bicchierai, Cecilia Boeri, Maninderpal Kaur Gill, Paolina Tonelli, Ermanno Vanzi, Diego De Benedetto, Donatello Cirone, Simonetta Bianchi, Alba Piacenti, Jacopo Nori, Vittorio Miele |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Digital mammography Breast imaging Biopsy Population Contrast Media Breast Neoplasms Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Breast cancer Internal Medicine Contrast Enhanced Digital Mammography Medicine Humans Breast education Retrospective Studies education.field_of_study Index Lesion business.industry CEDM medicine.disease Tomosynthesis Oncology 030220 oncology & carcinogenesis Surgery Female Radiology business Mammography |
| Zdroj: | The breast journalREFERENCES. 26(7) |
| ISSN: | 1524-4741 |
| Popis: | One of the most important indications for contrast-enhanced breast imaging is the presurgical breast cancer (BC) staging. This is a large-scale single-center experience which evaluates the role of CEDM in presurgical staging and its impact on surgical planning. The aims of this retrospective study were to define the diagnostic performance of CEDM in the presurgical setting and to identify which types of patients could benefit from having CEDM. We selected 326 patients with BC who underwent CEDM as preoperative staging and had breast cancer-related surgery at our institution. We analyzed those cases in which CEDM led to additional imaging or biopsy and those in which it changed the type of surgery that was planned according to conventional breast imaging (CI) techniques (digital mammography, tomosynthesis and bilateral handheld ultrasound). CEDM sensitivity in identifying the index lesion and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy in the correct preoperative staging of BC of the whole population and in various subgroups were calculated. CEDM sensitivity for the index lesion was 98.8% (322/326), which led to additional breast imaging in 23.6% (77/326) of patients and additional biopsies in 17.5% (57/326). CEDM changed the type of surgery in 18.4% (60/326). In the preoperative breast cancer staging, CEDM sensitivity, specificity, PPV, NPV, and accuracy produced results of 93%, 98%, 90%, 98%, and 97%, respectively. CEDM performance was better in patients with palpable lesions. CEDM has an excellent diagnostic performance in the presurgical staging of BC. Symptomatic patients with palpable lesions benefitted most from preoperative CEDM, with a statistically significant difference compared with nonpalpable. |
| Databáze: | OpenAIRE |
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