Please use this identifier to cite or link to this item: https://doi.org/10.1007/s00330-022-08906-0
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dc.titleImpact of contrast-enhanced mammography in surgical management of breast cancers for women with dense breasts: a dual-center, multi-disciplinary study in Asia
dc.contributor.authorGoh, Yonggeng
dc.contributor.authorChou, Chen-Pin
dc.contributor.authorChan, Ching Wan
dc.contributor.authorBuhari, Shaik Ahmad
dc.contributor.authorHartman, Mikael
dc.contributor.authorTang, Siau Wei
dc.contributor.authorNg, Celene Wei Qi
dc.contributor.authorPillay, Premilla
dc.contributor.authorChua, Wynne
dc.contributor.authorJagmohan, Pooja
dc.contributor.authorSterling, Eide
dc.contributor.authorWong, Ying Mei
dc.contributor.authorTan, Loon Ying
dc.contributor.authorOng, Han Yang
dc.contributor.authorPan, Huay-Ben
dc.contributor.authorLee, Herng-Sheng
dc.contributor.authorHung, Bao-Hui
dc.contributor.authorQuek, Swee Tian
dc.date.accessioned2023-02-22T00:29:50Z
dc.date.available2023-02-22T00:29:50Z
dc.date.issued2022-07-05
dc.identifier.citationGoh, 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
dc.identifier.issn0938-7994
dc.identifier.issn1432-1084
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/237397
dc.description.abstractObjective: 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.
dc.language.isoen
dc.publisherSPRINGER
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectRadiology, Nuclear Medicine & Medical Imaging
dc.subjectBreast density
dc.subjectBreast neoplasms
dc.subjectMammography
dc.subjectContrast media
dc.subjectClinical decision-making
dc.subjectCLINICAL-PRACTICE GUIDELINES
dc.subjectSPECTRAL MAMMOGRAPHY
dc.subjectDIGITAL MAMMOGRAPHY
dc.subjectMRI
dc.subjectTHERAPY
dc.subjectCESM
dc.subjectUS
dc.typeArticle
dc.date.updated2023-02-21T06:51:31Z
dc.contributor.departmentDIAGNOSTIC RADIOLOGY
dc.contributor.departmentSURGERY
dc.description.doi10.1007/s00330-022-08906-0
dc.description.sourcetitleEUROPEAN RADIOLOGY
dc.description.volume32
dc.description.issue12
dc.description.page8226-8237
dc.published.statePublished
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