Purpose
Breast cancer is the most common cancer and the leading cause of death from cancer among women throughout the world. In 2018, there were an estimated 2.1 million new cases of the disease and 627 000 deaths from breast cancer worldwide [1].
Surgery remains the breast cancer treatment mainstay, and early diagnosis allows for less aggressive surgical procedures. Conservative surgery necessitates an extremely precise disease extent evaluation to contain both the number of repeat excisions due to positive surgical margins and local recurrences arising from...
Methods and materials
Between 11.2018 and 02.2019 as part of preoperative planning 42 women at the ages from 25 to 70 years with confirmed newly diagnosed unilateral breast cancer were examined for the purposes of breast-conserving surgery. All patients underwent dual-energy contrast-enhanced spectral mammography (CESM). Contrast-enhanced mammography images were analyzed by two doctors independently of each other both having a background in contrast mammography for more than two years. All additional pathologic findings were confirmed by X-ray or ultrasound guided core-biopsy followed by histodiagnosis and immunohistochemistry (IHC test)....
Results
According to CESM data among 42 patients - 19 patients (45%) were ascertained with suspected multicentric breast lesions, 23 patients (55%) were confirmed to have a single tumor node and 6 patients (14%) had bilateral breast lesions. Test sensitivity was 100%, specificity - 88%, PPV - 86%, NPV - 100%, accuracy - 93%. Low differentiated atypical ductal hyperplasia (ADH) found in 3 patients (7%) was designated as true-positive results, since such lesions led to surgery volume extension. Thus, the volume of surgery and patient management...
Conclusion
Thus, CESM in the multiple breast lesions diagnosis is an effective method with high sensitivity, specificity, accuracy and the absence of false-negative results.
Many clinicians value the additional sensitivity of breast MRI in evaluating women with breast cancer for breast conservation therapy. The limited specificity of MRI, however, and its association with increased mastectomy rates has led to calls for a more selective use [8].
The use of CESM will reduce the number of relapses by clarifying the criteria for organ-preserving operations at the preoperative...
Personal information and conflict of interest
I. Smirnov; Moscow / RU- nothing to disclose V. V. Didenko; Moscow / RU- nothing to disclose K. A. Lesko; Moscow / RU-nothing to disclose
References
1 - GLOBOCAN 2018, International Agency for Research of Cancer- IARC
2 - Girardi, V., Carbognin, G., Camera, L., Baglio, I., Bucci, A., Bonetti, F., & Pozzi Mucelli, R. (2011).Multifocal, multicentric and contralateral breast cancers: breast MR imaging in the preoperative evaluation of patients with newly diagnosed breast cancer. La Radiologia Medica, 116(8), 1226–1238.doi:10.1007/s11547-011-0704-7
3 - Lalji, U., & Lobbes, M. (2014).Contrast-Enhanced Dual-Energy Mammography: A Promising New Imaging Tool in Breast Cancer Detection. Women’s Health, 10(3), 289–298.doi:10.2217/whe.14.18
4 - Carney, PA, Miglioretti, DL, Yankaskas, BC.Individual...