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Sophia Zackrisson, MD, PhD. Photo.

Sophia Zackrisson

Manager

Sophia Zackrisson, MD, PhD. Photo.

Added value of contrast-enhanced mammography (CEM) in staging of malignant breast lesions - A feasibility study

Author

  • Kristina Åhsberg
  • Anna Gardfjell
  • Emma Nimeus
  • Rogvi Rasmussen
  • Catharina Behmer
  • Sophia Zackrisson
  • Lisa Ryden

Summary, in English

Objectives: The aim of this feasibility study was to evaluate the added value of contrast-enhanced mammography (CEM) in preoperative staging of malignant breast lesions, beyond standard assessment with digital mammography and ultrasound, as a base for a future prospective randomized trial. Materials and methods: Forty-seven patients, with confirmed or strongly suspected malignant breast lesions after standard assessment (digital mammography (DM) and ultrasound (US)), scheduled for primary surgery, were invited to undergo CEM as an additional preoperative procedure. The primary endpoint was change in treatment due to CEM findings, defined as mastectomy instead of partial mastectomy or contrariwise, bilateral surgery instead of unilateral or neoadjuvant treatment instead of primary surgery. Accuracy in tumour extent estimation compared to histopathology was evaluated by Bland-Altman statistics. Number of extra biopsies and adverse events were recorded. Results: In 10/47 patients (21%), findings from CEM affected the primary treatment. Agreement with histopathology regarding extent estimation was better for CEM (mean difference - 1.36, SD ± 18.45) in comparison with DM (- 4.18, SD ± 26.20) and US (- 8.36, SD ± 24.30). Additional biopsies were taken from 19 lesions in 13 patients. Nine biopsies showed malignant outcome. No major adverse events occurred. Conclusion: The feasibility of preoperative additional CEM was found to be satisfactory without any serious negative effects. Results imply an added value of CEM in preoperative staging of breast cancer. Further evaluation in larger prospective randomized trials is needed.

Department/s

  • LUCC: Lund University Cancer Centre
  • Breast Cancer Surgery
  • Breast cancer Proteogenomics
  • EpiHealth: Epidemiology for Health
  • Radiology Diagnostics, Malmö

Publishing year

2020-05-21

Language

English

Publication/Series

World Journal of Surgical Oncology

Volume

18

Document type

Journal article

Publisher

BioMed Central (BMC)

Topic

  • Surgery
  • Radiology, Nuclear Medicine and Medical Imaging
  • Cancer and Oncology

Keywords

  • Breast cancer
  • CEM
  • CESM
  • Contrast-enhanced mammography
  • Contrast-enhanced spectral mammography
  • Preoperative staging

Status

Published

Research group

  • Breast Cancer Surgery
  • Breast cancer Proteogenomics
  • Radiology Diagnostics, Malmö

ISBN/ISSN/Other

  • ISSN: 1477-7819