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. 2024 Sep;31(5):851-857.
doi: 10.1007/s12282-024-01599-x. Epub 2024 May 29.

Contrast-enhanced mammography in the management of breast architectural distortions and avoidance of unnecessary biopsies

Chiara Bellini  1 , Francesca Pugliese  2 , Giulia Bicchierai  2 , Francesco Amato  3 , Diego De Benedetto  2 , Federica Di Naro  2 , Cecilia Boeri  2 , Ermanno Vanzi  2 , Giuliano Migliaro  2 , Ludovica Incardona  2 , Cinzia Tommasi  4 , Lorenzo Orzalesi  4 , Vittorio Miele  5 , Jacopo Nori  2
Affiliations

Contrast-enhanced mammography in the management of breast architectural distortions and avoidance of unnecessary biopsies

Chiara Bellini et al. Breast Cancer. 2024 Sep.

Abstract

Background: To assess contrast-enhanced mammography (CEM) in the management of BI-RADS3 breast architectural distortions (AD) in digital breast tomosynthesis (DBT).

Methods: We retrospectively reviewed 328 women with 332 ADs detected on DBT between 2017 and 2021 and selected those classified as BI-RADS3 receiving CEM as problem-solving. In CEM recombined images, we evaluated AD's contrast enhancement (CE) according to its presence/absence, type, and size. AD with enhancement underwent imaging-guided biopsy while AD without enhancement follow-up or biopsy if detected in high/intermediate-risk women.

Results: AD with enhancement were 174 (52.4%): 72 (41.4%) were malignant lesions, 102 (59.6%) false positive results: 28 (16%) B3 lesions, and 74 (42.5%) benign lesions. AD without enhancement were 158 (47.6%): 26 (16.5%) were subjected to biopsy (1 malignant and 25 benign) while the other 132 cases were sent to imaging follow-up, still negative after two years. CEM's sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and accuracy were 98.63%, 60.62%, 41.38%, 99.37%, and 68.98%. The AUC determined by ROC was 0.796 (95% CI, 0.749-0.844).

Conclusion: CEM has high sensitivity and NPV in evaluating BI-RADS3 AD and can be a complementary tool in assessing AD, avoiding unnecessary biopsies without compromising cancer detection.

Keywords: Breast cancer; CEM; Distortions.

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References

    1. Breast Imaging Reporting & Data System. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Bi-Rads . Accessed 27 Jan 2020.
    1. Gaur S, Dialani V, Slanetz PJ, Eisenberg RL. Architectural distortion of the breast. Am J Roentgenol. 2013;201:W662–70. https://doi.org/10.2214/AJR.12.10153 . - DOI
    1. Si L, Zhai R, Liu X, et al. MRI in the differential diagnosis of primary architectural distortion detected by mammography. Diagn Interv Radiol. 2016;22:141–50. https://doi.org/10.5152/dir.2016.15017 . - DOI - PubMed - PMC
    1. Partyka L, Lourenco AP, Mainiero MB. Detection of mammographically occult architectural distortion on digital breast tomosynthesis screening: initial clinical experience. AJR Am J Roentgenol. 2014;203:216–22. https://doi.org/10.2214/AJR.13.11047 . - DOI - PubMed
    1. Ciatto S, Houssami N, Bernardi D, et al. Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): a prospective comparison study. Lancet Oncol. 2013;14:583–9. https://doi.org/10.1016/S1470-2045(13)70134-7 . - DOI - PubMed

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