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Comparative Study
. 2022 Jan 1;23(1):233-239.
doi: 10.31557/APJCP.2022.23.1.233.

Are All Views with and without Displacement Maneuver Necessary in Augmentation Mammography? Putting Numbers Into Perspective

Lilian Soares Couto  1 , Ruffo Freitas-Junior  1 , Rosangela Silveira Corrêa  1 , Macelo Vilela Lauar  1 , Selma Pace Bauab  1 , Linei Augusta Brolini Dellê Urban  1 , Jorge Luiz Oliveira Cruvinel-Filho  1 , Leonardo Ribeiro Soares  1 , Ricardo Francalacci Savaris  1
Affiliations
Comparative Study

Are All Views with and without Displacement Maneuver Necessary in Augmentation Mammography? Putting Numbers Into Perspective

Lilian Soares Couto et al. Asian Pac J Cancer Prev. .

Abstract

Objective: Augmentation implants pose a challenge for radiologists. Displacing the implant allows slightly more breast tissue to be visualized than the standard compression views. The objective of this study was to verify the agreement between craniocaudal (CC) views and CC with implant displacement (CC-ID), mediolateral oblique (MLO) and MLO-ID and the inter- and intraobserver agreement of mammographic images for finding abnormal images.

Methods: The main outcomes [BI-RADS® normal=1,2; abnormal=3,4,5)] were analysed by 3 readers (reader1; reader 2, 1st round, reader 2, 2nd round) in 360 women with breast implants. Comparison between CC/CC-ID and MLO/MLO-ID, and degree of agreement for mammographic images between researchers were made using Kappa index. Proportions were calculated using a 95% confidence interval (95%CI).

Results: A total of 87 abnormal findings were identified by reader 2, 2nd round. Abnormal findings were observed in CC-ID=18.8% (68 out of 360; 95%CI=15.1%-23.2%) compared to CC=10.8% (39 out of 360; 95%CI=8%-14.4%, k=0.49); in MLO=10.5% (38 out of 360; 95%CI=7.7%-14.1%) compared to MLO-ID=15.8% (57 out of 360; 95%CI=12.4%-19.9%, k=0.55). The CC-ID was the view that singly identified more abnormal findings (20 out of 87; 23%; 95%CI=15.4% to 32.8%) and the CC was the view that least detected abnormal findings (1 out 87; 95%CI=0.2% to 6.2%). The inter- and intraobserver agreement between readers views was 0.67 and 0.74 respectively.

Conclusions: In women with breast augmentation implants, all views are necessary to identify breast tissue abnormalities. In our sample, the inter- and intraobserver agreement were "substantial".

Keywords: Breast; Breast Implants; Breast augmentation; breast cancer; mammography.

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Conflict of interest statement

The authors declare that they have no competing interests; neither financial nor non-financial interests.

Figures

Figure 1
Figure 1
Mass was Detected Only in the CC-ID View
Figure 2
Figure 2
Grouped Calcifications Detected Only in the ID Views
See this image and copyright information in PMC

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