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

Åhsberg, Kristina LU ; Gardfjell, Anna LU orcid ; Nimeus, Emma LU ; Rasmussen, Rogvi ; Behmer, Catharina ; Zackrisson, Sophia LU and Ryden, Lisa LU orcid (2020) In World Journal of Surgical Oncology 18.
Abstract

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... (More)

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. 

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast cancer, CEM, CESM, Contrast-enhanced mammography, Contrast-enhanced spectral mammography, Preoperative staging
in
World Journal of Surgical Oncology
volume
18
article number
100
publisher
BioMed Central (BMC)
external identifiers
  • pmid:32438917
  • scopus:85085158136
ISSN
1477-7819
DOI
10.1186/s12957-020-01865-0
language
English
LU publication?
yes
id
3c8c67c5-42f8-441e-9a7c-98c134f77cac
date added to LUP
2020-06-16 14:07:22
date last changed
2024-04-17 10:25:54
@article{3c8c67c5-42f8-441e-9a7c-98c134f77cac,
  abstract     = {{<p>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. </p>}},
  author       = {{Åhsberg, Kristina and Gardfjell, Anna and Nimeus, Emma and Rasmussen, Rogvi and Behmer, Catharina and Zackrisson, Sophia and Ryden, Lisa}},
  issn         = {{1477-7819}},
  keywords     = {{Breast cancer; CEM; CESM; Contrast-enhanced mammography; Contrast-enhanced spectral mammography; Preoperative staging}},
  language     = {{eng}},
  month        = {{05}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{World Journal of Surgical Oncology}},
  title        = {{Added value of contrast-enhanced mammography (CEM) in staging of malignant breast lesions - A feasibility study}},
  url          = {{http://dx.doi.org/10.1186/s12957-020-01865-0}},
  doi          = {{10.1186/s12957-020-01865-0}},
  volume       = {{18}},
  year         = {{2020}},
}