Contrast-enhanced mammography in the assessment of residual disease after neoadjuvant treatment Journal Article
| Authors: | Hogan, M. P.; Horvat, J. V.; Ross, D. S.; Sevilimedu, V.; Jochelson, M. S.; Kirstein, L. J.; Goldfarb, S. B.; Comstock, C. E.; Sung, J. S. |
| Article Title: | Contrast-enhanced mammography in the assessment of residual disease after neoadjuvant treatment |
| Abstract: | Purpose: To investigate the utility of contrast-enhanced mammography (CEM) as an alternative to breast MRI for the evaluation of residual disease after neoadjuvant treatment (NAT). Methods: This prospective study enrolled consecutive women undergoing NAT for breast cancer from July 2017–July 2019. Breast MRI and CEM exams performed after completion of NAT were read independently by two breast radiologists. Residual disease and lesion size on MRI and CEM recombined (RI) and low-energy images (LEI) were compared. Histopathology was considered the reference standard. Statistical analysis was performed using McNemar’s and Leisenring’s tests. Multiple comparison adjustment was made using Bonferroni procedure. Lesion sizes were correlated using Kendall’s tau coefficient. Results: There were 110 participants with 115 breast cancers. Residual disease (invasive cancer or ductal carcinoma in situ) was detected in 83/115 (72%) lesions on pathology, 71/115 (62%) on MRI, 55/115 (48%) on CEM RI, and 75/115 (65%) on CEM LEI. When using multiple comparison adjustment, no significant differences were detected between MRI combined with CEM LEI and CEM RI combined with CEM LEI, in terms of accuracy (MRI: 77%, CEM: 72%; p ≥ 0.99), sensitivity (MRI: 88%, CEM: 81%; p ≥ 0.99), specificity (MRI: 47%, CEM: 50%; p ≥ 0.99), PPV (MRI: 81%, CEM: 81%; p ≥ 0.99), or NPV (MRI: 60%, CEM: 50%; p ≥ 0.99). Size correlation between pathology and both MRI combined with CEM LEI and CEM RI combined with CEM LEI was moderate: τ = 0. 36 vs 0.33 (p ≥ 0.99). Conclusion: Contrast-enhanced mammography is an acceptable alternative to breast MRI for the detection of residual disease after neoadjuvant treatment. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. |
| Keywords: | neoadjuvant therapy; nuclear magnetic resonance imaging; magnetic resonance imaging; prospective study; prospective studies; breast; pathology; diagnostic imaging; breast neoplasms; mammography; minimal residual disease; neoplasm, residual; breast tumor; contrast medium; contrast media; procedures; humans; human; female |
| Journal Title: | Breast Cancer Research and Treatment |
| Volume: | 198 |
| Issue: | 2 |
| ISSN: | 0167-6806 |
| Publisher: | Springer |
| Date Published: | 2023-04-01 |
| Start Page: | 349 |
| End Page: | 359 |
| Language: | English |
| DOI: | 10.1007/s10549-023-06865-8 |
| PUBMED: | 36754936 |
| PROVIDER: | scopus |
| PMCID: | PMC10375516 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in PubMed and PDF -- Corresponding author is MSK author: Joao V. Horvat -- Source: Scopus |
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