Assessment of the diagnostic accuracy of contrast-enhanced digital mammography in the differentiation between benign and malignant breast mass lesions

Abstract

Background: It is important to find an accurate and cost-effective tool for the early diagnosis of breast cancer which is the most common cancer in women worldwide. Contrast-Enhanced Digital Mammography(CEDM) is an emerging modality in depicting abnormalities seen at screening mammography and it could demonstrate disease extension and help in detecting response to therapy. This study aimed to evaluate the accuracy of CEDM in the diagnosis and differentiation between benign and malignant breast masses and mass-like lesions. Patients & methods: This prospective study included 100 female patients with 154 breast lumps, their ages ranged from 30-75 years (Mean= 42±5.3) who referred with a suspicious breast lump. Informed consent was obtained from all patients. All patients were subjected to local breast examination of both breast sides, renal function tests; Conventional mammography (CM), breast ultrasonography (U/S), and contrast-enhanced digital mammography (CEDM). Diagnoses confirmed by biopsy and histopathology results that used as a gold standard. Results: The 154 studied lesions found to be: 122 malignant neoplastic lesions (79.22%) and 32 benign lesions (20.78%) according to the histopathology results.CEDM was found to have higher sensitivity (97.56%), specificity (93.55%), and accuracy (96.75%) when compared to combined CM and U/S results that showed sensitivity (62.30%), specificity (68.75%), and accuracy (63.64%), Conclusion: Contrast-enhanced digital mammography found to be a low-cost effective diagnostic method in the differentiation between benign and malignant breast mass lesions that can improve diagnostic accuracy and increase the cancer detection rate.