Contrast-enhanced mammography for women with palpable breast abnormalities Journal Article
| Authors: | Amir, T.; Pinker, K.; Sevilimedu, V.; Hughes, M.; Keating, D. T.; Sung, J. S.; Jochelson, M. S. |
| Article Title: | Contrast-enhanced mammography for women with palpable breast abnormalities |
| Abstract: | Rationale and Objectives: To examine the role of contrast-enhanced mammography (CEM) in the work-up of palpable breast abnormalities. Materials and Methods: In this single-center combination prospective-retrospective study, women with palpable breast abnormalities underwent CEM evaluation prospectively, comprising the acquisition of low energy (LE) images and recombined images (RI) which depict enhancement, followed by targeted ultrasound (US). Two independent readers retrospectively reviewed the imaging and assigned BI-RADS assessment based on LE alone, LE plus US, RI with LE plus US (CEM plus US), and RI alone. Pathology results or 1-year follow-up imaging served as the reference standard. Results: 237 women with 262 palpable abnormalities were included (mean age, 51 years). Of the 262 palpable abnormalities, 116/262 (44%) had no imaging correlate and 242/262 (92%) were benign. RI alone had better specificity compared to LE plus US (Reader 1, 94% versus 89% (p = 0.009); Reader 2, 93% versus 88% (p = 0.03)), better positive predictive value (Reader 1, 52% versus 42% (p = 0.04); Reader 2, 53% versus 42% (p = 0.04)), and better accuracy (Reader 1, 93% versus 89% (p = 0.05); Reader 2, 93% versus 90% (p = 0.06)). CEM plus US was not significantly different in performance metrics versus LE plus US. Conclusion: RI had better specificity compared to LE in combination with US. There was no difference in performance between CEM plus US and LE plus US, likely reflecting the weight US carries in radiologist decision-making. However, the results indicate that the absence of enhancement on RI in the setting of palpable lesions may help avoid benign biopsies. © 2024 The Association of University Radiologists |
| Keywords: | adult; controlled study; human tissue; aged; middle aged; retrospective studies; major clinical study; cancer risk; follow up; diagnostic accuracy; prospective study; sensitivity and specificity; prospective studies; clinical practice; breast; practice guideline; diagnostic imaging; breast neoplasms; retrospective study; mammography; contrast enhancement; breast tumor; predictive value of tests; iohexol; premenopause; postmenopause; personal experience; stereotactic biopsy; ultrasonography; predictive value; clinical examination; breast disease; diagnostic test accuracy study; breast density; procedures; breast imaging reporting and data system; humans; human; female; article; contrast-enhanced mammography; contrast enhanced mammography; ductal breast carcinoma in situ |
| Journal Title: | Academic Radiology |
| Volume: | 31 |
| Issue: | 4 |
| ISSN: | 1076-6332 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2024-04-01 |
| Start Page: | 1231 |
| End Page: | 1238 |
| Language: | English |
| DOI: | 10.1016/j.acra.2023.10.027 |
| PUBMED: | 37949703 |
| PROVIDER: | scopus |
| PMCID: | PMC11660080 |
| DOI/URL: | |
| Notes: | PDF incorrectly ascribed Delia M. Keating's middle initial as "T." -- The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Maxine S. Jochelson -- Source: Scopus |
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