Contrast-enhanced digital mammography screening for intermediate-risk women with a history of lobular neoplasia Journal Article


Authors: Hogan, M. P.; Amir, T.; Sevilimedu, V.; Sung, J.; Morris, E. A.; Jochelson, M. S.
Article Title: Contrast-enhanced digital mammography screening for intermediate-risk women with a history of lobular neoplasia
Abstract: OBJECTIVE. The objective of this study was to assess to the role of contrast-enhanced digital mammography (CEDM) as a screening tool in women at intermediate risk for developing breast cancer due to a personal history of lobular neoplasia without additional risk factors. MATERIALS AND METHODS. In this institutional review board–approved, observational, retrospective study, we reviewed our radiology department database to identify patients with a personal history of breast biopsy yielding lobular neoplasia who underwent screening CEDM at our institution between December 2012 and February 2019. A total of 132 women who underwent 306 CEDM examinations were included. All CEDM examinations were interpreted by dedicated breast imaging radiologists in conjunction with a review of the patient’s clinical history and available prior breast imaging. In statistical analysis, sensitivity, specificity, NPV, positive likelihood ratio, and accuracy of CEDM in detecting cancer were determined, with pathology or 12-month imaging follow-up serving as the reference standard. RESULTS. CEDM detected cancer in six patients and showed an overall sensitivity of 100%, specificity of 88% (95% CI, 84–92%), NPV of 100%, and accuracy of 88% (95% CI, 84–92%). The positive likelihood ratio of 8.33 suggested that CEDM findings are 8.3 times more likely to be positive in an individual with breast cancer when compared with an individual without the disease. CONCLUSION. CEDM shows promise as a breast cancer screening examination in patients with a personal history of lobular neoplasia. Continued investigation with a larger patient population is needed to determine the true sensitivity and positive predictive value of CEDM for these patients. © American Roentgen Ray Society.
Keywords: adult; aged; middle aged; retrospective studies; sensitivity and specificity; breast; diagnostic imaging; breast neoplasms; retrospective study; risk; mammography; image enhancement; screening; breast tumor; contrast medium; contrast media; lobular carcinoma in situ; lobular neoplasia; carcinoma, lobular; atypical lobular hyperplasia; radiographic image enhancement; lobular carcinoma; procedures; humans; human; female; contrast-enhanced digital mammography
Journal Title: American Journal of Roentgenology
Volume: 216
Issue: 6
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2021-06-01
Start Page: 1486
End Page: 1491
Language: English
DOI: 10.2214/ajr.20.23480
PUBMED: 33787291
PROVIDER: scopus
DOI/URL:
Notes: Review -- Export Date: 1 July 2021 -- Source: Scopus
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MSK Authors
  1. Janice Sinae Sung
    48 Sung
  2. Elizabeth A Morris
    325 Morris
  3. Tali Amir
    3 Amir