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https://doi.org/10.1007/s00330-022-08906-0
Title: | Impact of contrast-enhanced mammography in surgical management of breast cancers for women with dense breasts: a dual-center, multi-disciplinary study in Asia | Authors: | Goh, Yonggeng Chou, Chen-Pin Chan, Ching Wan Buhari, Shaik Ahmad Hartman, Mikael Tang, Siau Wei Ng, Celene Wei Qi Pillay, Premilla Chua, Wynne Jagmohan, Pooja Sterling, Eide Wong, Ying Mei Tan, Loon Ying Ong, Han Yang Pan, Huay-Ben Lee, Herng-Sheng Hung, Bao-Hui Quek, Swee Tian |
Keywords: | Science & Technology Life Sciences & Biomedicine Radiology, Nuclear Medicine & Medical Imaging Breast density Breast neoplasms Mammography Contrast media Clinical decision-making CLINICAL-PRACTICE GUIDELINES SPECTRAL MAMMOGRAPHY DIGITAL MAMMOGRAPHY MRI THERAPY CESM US |
Issue Date: | 5-Jul-2022 | Publisher: | SPRINGER | Citation: | Goh, Yonggeng, Chou, Chen-Pin, Chan, Ching Wan, Buhari, Shaik Ahmad, Hartman, Mikael, Tang, Siau Wei, Ng, Celene Wei Qi, Pillay, Premilla, Chua, Wynne, Jagmohan, Pooja, Sterling, Eide, Wong, Ying Mei, Tan, Loon Ying, Ong, Han Yang, Pan, Huay-Ben, Lee, Herng-Sheng, Hung, Bao-Hui, Quek, Swee Tian (2022-07-05). Impact of contrast-enhanced mammography in surgical management of breast cancers for women with dense breasts: a dual-center, multi-disciplinary study in Asia. EUROPEAN RADIOLOGY 32 (12) : 8226-8237. ScholarBank@NUS Repository. https://doi.org/10.1007/s00330-022-08906-0 | Abstract: | Objective: To evaluate the impact of pre-operative contrast-enhanced mammography (CEM) in breast cancer patients with dense breasts. Methods: We conducted a retrospective review of 232 histologically proven breast cancers in 200 women (mean age: 53.4 years ± 10.2) who underwent pre-surgical CEM imaging across two Asian institutions (Singapore and Taiwan). Majority (95.5%) of patients had dense breast tissue (BI-RADS category C or D). Surgical decision was recorded in a simulated blinded multi-disciplinary team setting on two separate scenarios: (i) pre-CEM setting with standard imaging, and clinical and histopathological results; and (ii) post-CEM setting with new imaging and corresponding histological findings from CEM. Alterations in surgical plan (if any) because of CEM imaging were recorded. Predictors CEM of patients who benefitted from surgical plan alterations were evaluated using logistic regression. Results: CEM resulted in altered surgical plans in 36 (18%) of 200 patients in this study. CEM discovered clinically significant larger tumor size or extent in 24 (12%) patients and additional tumors in 12 (6%) patients. CEM also detected additional benign/false-positive lesions in 13 (6.5%) of the 200 patients. Significant predictors of patients who benefitted from surgical alterations found on multivariate analysis were pre-CEM surgical decision for upfront breast conservation (OR, 7.7; 95% CI, 1.9-32.1; p = 0.005), architectural distortion on mammograms (OR, 7.6; 95% CI, 1.3–42.9; p =.022), and tumor size of ≥ 1.5 cm (OR, 1.5; 95% CI, 1.0-2.2; p =.034). Conclusion: CEM is an effective imaging technique for pre-surgical planning for Asian breast cancer patients with dense breasts. Key Points: • CEM significantly altered surgical plans in 18% (nearly 1 in 5) of this Asian study cohort with dense breasts. • Significant patient and imaging predictors for surgical plan alteration include (i) patients considered for upfront breast-conserving surgery; (ii) architectural distortion lesions; and (iii) tumor size of ≥ 1.5 cm. • Additional false-positive/benign lesions detected through CEM were uncommon, affecting only 6.5% of the study cohort. | Source Title: | EUROPEAN RADIOLOGY | URI: | https://scholarbank.nus.edu.sg/handle/10635/237397 | ISSN: | 0938-7994 1432-1084 |
DOI: | 10.1007/s00330-022-08906-0 |
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