Skip to main content
Top
Published in: Breast Cancer 1/2017

01-01-2017 | Original Article

Diagnostic accuracy of contrast-enhanced spectral mammography in comparison to conventional full-field digital mammography in a population of women with dense breasts

Authors: Miki Mori, Sadako Akashi-Tanaka, Satoko Suzuki, Murasaki Ikeda Daniels, Chie Watanabe, Masanori Hirose, Seigo Nakamura

Published in: Breast Cancer | Issue 1/2017

Login to get access

Abstract

Background

Contrast-enhanced spectral mammography to compare clinical efficacy of contrast-enhanced spectral mammography (CESM) and conventional digital mammography (MMG) with histopathology as gold standard in dense breasts.

Patients and methods

A total of 143 breasts of 72 women who underwent CESM and MMG between 2011 and 2014 at Showa University Hospital were analyzed.

Results

129 (90.2 %) of 143 breasts revealed dense breasts on MMG. 58 (40.6 %) of 143 breasts were diagnosed with breast cancer at histopathology. The remaining 85 breasts were diagnosed with benign findings after image assessments and/or core needle biopsy. CESM revealed 8 false-negative cases among 58 breast cancer cases (sensitivity 86.2 %) and 5 false-positive cases (specificity 94.1 %). Accuracy was 90.9 %. Conventional MMG was assessed true positive in 31 of 58 breast cancer cases (sensitivity 53.4 %) and false positive in 12 cases (specificity 85.9 %). Accuracy was 72.7 %. Sensitivity (p < 0.001), specificity (p = 0.016) and accuracy (p < 0.001) were significantly higher on CESM compared to MMG. MMG missed malignancy in 27 breasts. Of these, 25 were dense breasts. Of these 25, 20 (80.0 %) breasts were positive on CESM.

Conclusion

These findings suggest that CESM offers superior clinical performance compared to MMG. Use of CESM may decrease false negatives especially for women with dense breasts.
Literature
1.
go back to reference Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening MMG, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology. 2002;225(1):165–75.CrossRefPubMed Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening MMG, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology. 2002;225(1):165–75.CrossRefPubMed
2.
go back to reference Byrne C, Schairer C, Wolfe J, Parekh N, Salane M, Brinton LA, et al. Mammographic features and breast cancer risk: effects with time, age, and menopause status. J Natl Cancer Inst. 1995;87:1622–9.CrossRefPubMed Byrne C, Schairer C, Wolfe J, Parekh N, Salane M, Brinton LA, et al. Mammographic features and breast cancer risk: effects with time, age, and menopause status. J Natl Cancer Inst. 1995;87:1622–9.CrossRefPubMed
3.
go back to reference Warner E, Lockwood G, Tritchler D, Boyd NF. The risk of breast cancer associated with mammographic parenchymal patterns: a meta-analysis of the published literature to examine the effect of method of classification. Cancer Detect Prev. 1992;16:67–72.PubMed Warner E, Lockwood G, Tritchler D, Boyd NF. The risk of breast cancer associated with mammographic parenchymal patterns: a meta-analysis of the published literature to examine the effect of method of classification. Cancer Detect Prev. 1992;16:67–72.PubMed
4.
go back to reference Brisson J, Merletti F, Sadowsky NL, Twaddle JA, Morrison AS, Cole P. Mammographic features of the breast and breast cancer risk. Am J Epidemiol. 1982;115:428–37.PubMed Brisson J, Merletti F, Sadowsky NL, Twaddle JA, Morrison AS, Cole P. Mammographic features of the breast and breast cancer risk. Am J Epidemiol. 1982;115:428–37.PubMed
5.
go back to reference Boyd NF, Byng JW, Jong RA, Fishell EK, Little LE, Miller AB, et al. Quantitative classification of mammographic density and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst. 1995;87:670–5.CrossRefPubMed Boyd NF, Byng JW, Jong RA, Fishell EK, Little LE, Miller AB, et al. Quantitative classification of mammographic density and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst. 1995;87:670–5.CrossRefPubMed
6.
go back to reference Ursin G, Ma H, Wu AH, Bernstein L, Salane M, Parisky YR, et al. Mammographic density and breast cancer in three ethnic groups. Cancer Epidemiol Biomar- kers Prev. 2003;12:332–8. Ursin G, Ma H, Wu AH, Bernstein L, Salane M, Parisky YR, et al. Mammographic density and breast cancer in three ethnic groups. Cancer Epidemiol Biomar- kers Prev. 2003;12:332–8.
7.
go back to reference Mammography Reporting System. ACR BI-RADS Atlas 5th Edition. American College of Radiology; 2013. p.121–140. Mammography Reporting System. ACR BI-RADS Atlas 5th Edition. American College of Radiology; 2013. p.121–140.
8.
go back to reference Pisano ED, Hendrick RE, Yaffe MJ, Baum JK, Acharyya S, Cormack JB, et al. Diagnostic accuracy of digital versus film mammography: exploratory analysis of selected population subgroups in DMIST 1. Radiology. 2008;246(2):376–83.CrossRefPubMedPubMedCentral Pisano ED, Hendrick RE, Yaffe MJ, Baum JK, Acharyya S, Cormack JB, et al. Diagnostic accuracy of digital versus film mammography: exploratory analysis of selected population subgroups in DMIST 1. Radiology. 2008;246(2):376–83.CrossRefPubMedPubMedCentral
9.
go back to reference Fallenberg EM, Dromain C, Diekmann F, Renz DM, Amer H, Ingold-Heppner B, et al. Contrast-enhanced spectral mammography: doesmammography provide additional clinical benefits or can some radiation exposure be avoided? Breast Cancer Res Treat. 2014;146(2):371–81.CrossRefPubMed Fallenberg EM, Dromain C, Diekmann F, Renz DM, Amer H, Ingold-Heppner B, et al. Contrast-enhanced spectral mammography: doesmammography provide additional clinical benefits or can some radiation exposure be avoided? Breast Cancer Res Treat. 2014;146(2):371–81.CrossRefPubMed
10.
go back to reference Lobbes MB, Lalji U, Houwers J, Nijssen EC, Nelemans PJ, van Roozendaal L, et al. Contrast-enhanced spectral mammography in patients referred from thebreast cancer screening programme. Eur Radiol. 2014;24(7):1668–76.PubMed Lobbes MB, Lalji U, Houwers J, Nijssen EC, Nelemans PJ, van Roozendaal L, et al. Contrast-enhanced spectral mammography in patients referred from thebreast cancer screening programme. Eur Radiol. 2014;24(7):1668–76.PubMed
11.
go back to reference Cheung YC, Lin YC, Wan YL, Huang PC, Lo YF, Tsai HP, et al. Diagnostic performance of dual-energy contrast-enhanced subtracted mammography in dense breasts compared to mammography alone: interobserver blind-reading analysis. Eur Radiol. 2014;24:2394–403.CrossRefPubMed Cheung YC, Lin YC, Wan YL, Huang PC, Lo YF, Tsai HP, et al. Diagnostic performance of dual-energy contrast-enhanced subtracted mammography in dense breasts compared to mammography alone: interobserver blind-reading analysis. Eur Radiol. 2014;24:2394–403.CrossRefPubMed
12.
go back to reference Chen Z, Wu AH, Gauderman WJ, Bernstein L, Ma H, Pike MC, et al. Does mammographic density reflect ethnic differences in breast cancer incidence rates? Am J Epidemiol. 2004;159(2):140–7.CrossRefPubMed Chen Z, Wu AH, Gauderman WJ, Bernstein L, Ma H, Pike MC, et al. Does mammographic density reflect ethnic differences in breast cancer incidence rates? Am J Epidemiol. 2004;159(2):140–7.CrossRefPubMed
13.
go back to reference del Carmen MG, Halpern EF, Kopans DB, Moy B, Moore RH, Goss PE, et al. Mammographic breast density and race. AJR Am J Roentgenol. 2007;188(4):1147–50.CrossRefPubMed del Carmen MG, Halpern EF, Kopans DB, Moy B, Moore RH, Goss PE, et al. Mammographic breast density and race. AJR Am J Roentgenol. 2007;188(4):1147–50.CrossRefPubMed
14.
go back to reference Ellison-Loschmann L, McKenzie F, Highnam R, Cave A, Walker J, Jeffreys M. Age and ethnic differences in volumetric breast density in New Zealand women: a cross-sectional study. PLoS One. 2013;8(7):e70217.CrossRefPubMedPubMedCentral Ellison-Loschmann L, McKenzie F, Highnam R, Cave A, Walker J, Jeffreys M. Age and ethnic differences in volumetric breast density in New Zealand women: a cross-sectional study. PLoS One. 2013;8(7):e70217.CrossRefPubMedPubMedCentral
15.
go back to reference Colin C, Schott AM, Valette PJ. Mammographic density is not a worthwhile examination to distinguish high cancer risk women in screening. Eur Radiol. 2014;24(10):2412–6.CrossRefPubMed Colin C, Schott AM, Valette PJ. Mammographic density is not a worthwhile examination to distinguish high cancer risk women in screening. Eur Radiol. 2014;24(10):2412–6.CrossRefPubMed
Metadata
Title
Diagnostic accuracy of contrast-enhanced spectral mammography in comparison to conventional full-field digital mammography in a population of women with dense breasts
Authors
Miki Mori
Sadako Akashi-Tanaka
Satoko Suzuki
Murasaki Ikeda Daniels
Chie Watanabe
Masanori Hirose
Seigo Nakamura
Publication date
01-01-2017
Publisher
Springer Japan
Published in
Breast Cancer / Issue 1/2017
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-016-0681-8

Other articles of this Issue 1/2017

Breast Cancer 1/2017 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine