Predictors of responses and sexual function for women in the St George breast boost randomized trial (StGBBT)

Abstract

s / The Breast 24 (2015) 302e307 304 Resonance Imaging (CEMRI) is currently the most sensitive imaging technique for breast cancer detection; however, it suffers from many drawbacks including high cost, timely accessibility, patient contraindications and low specificity. Previous studies have shown that contrast enhanced spectral mammography (CESM) may have similar diagnostic capability to CEMRI without these associated costs (2). Methods: The study included patients with biopsy proven breast cancer aged 21 years, fit for surgery, and excluded patients with contra-indications to intravenous contrast or CEMRI, candidates for neo-adjuvant chemotherapy, or who had pure in situ carcinoma. Participants underwent both CESM and CEMRI. Studies were independently double read and results benchmarked against the final surgical histopathology, core biopsy histology or one year follow-up imaging. CESM and CEMRI were compared for 1) detection of additional lesions 2) ability to size the index lesion 3) influence on surgical plan and 4) participant satisfaction. Results: A minimum of 19 participants was analysed for each study objective. For the detection of additional lesions (n1⁄421), the addition of CESM to conventional imaging increased sensitivity from 50% to 67% with specificity unchanged (47%). Addition of CEMRI to standard imaging increased sensitivity from 50% to 100% but with considerable reduction in specificity (47% to 7%). The geometric mean of index lesion size at pathology was similar for CESM and CEMRI (n1⁄424). For 19 patients, CESM and CEMRI had identical influence on the surgery plan. Participants preferred CESM to CEMRI (n1⁄434, p1⁄40.0005). Conclusions: Results so far suggest CESM has similar diagnostic capacity to CEMRI and is preferred by patients.