Assessing tumor extent on contrast-enhanced digital mammography versus full-field digital mammography and ultrasound

Publication date: Available online 12 July 2017
Source:Clinical Imaging
Author(s): Bhavika Patel, Sandra Alheli Garza, Sarah Eversman, Yania Lopez-Alvarez, Heidi Kosiorek, Barbara Pockaj
ObjectivesThe objective of our study was to compare breast tumor size measurements on full-field digital mammography (FFDM), contrast-enhanced Digital mammography (CEDM), and ultrasound (US), with histologic tumor size used as the reference standard.Material and methodsThe study comprised 88 women with newly diagnosed breast cancer who underwent FFDM and CEDM. Breast density and maximum tumor measurements were recorded: 88 women had FFDM and CEDM; 74 also had US.ResultsPearson correlation coefficients for FFDM, US, and CEDM vs histopathology were 0.598, 0.639, and 0.859, respectively (P<0.001). Of the 88 patients, 48 had dense and 40 had nondense breasts. The following correlation coefficients were calculated for dense breasts: histopathology vs FFDM (0.555), US (0.633), and CEDM (0.843) (P<0.001); for nondense breasts, they were FFDM (0.618), US (0.512), and CEDM (0.885) (P<0.001). For size difference, the mean (SD) for histopathology vs FFDM, US, and CEDM was −1.3 (11.9) mm, −2.8 (11.1) mm, and 2.9 (9.5) mm, respectively. Limits of agreement were −24.8 to 22.0mm, −24.5 to 18.8mm, and −15.6 to 21.4mm, respectively.ConclusionsIn biopsy proven patients with biopsy-proven malignancy, size measurements coreelated well histopathologic size, and were higher on CEDM than those for FFDM and US in patients with dense or nondense breasts. The added value of CEDM as a supplement to FFDM in determining tumor size, however, was greater in patients with dense breasts. CEDM may be a promising alternative preoperative measurement tool for breast cancer patients with dense breasts or limited access or contraindications to MRI.



http://ift.tt/2uSs4Kc