Abstract
BackgroundPrimary breast edema can cause marked increase in skin thickness, breast density and echogenicity due to dense breast tissue filled with fluid and so causes subsequent significant attenuation of both the x-ray and ultrasound beams. The study aim is to assess the value of contrast-enhanced digital mammography (CEDM) in assessment and characterization of the obscured underlying breast lesions in cases of primary breast edema.ResultsFifty five female participants were evaluated, of median age 51 years old and IQR 21. CEDM shows high sensitivity and specificity in the lesion detection as well as local extension delineation in cases associated with primary breast edema. It was accurate in detection of multifocal/multi-centric disease. CEDM is considered as a good negative test in cases of metastatic axillary lymph nodes to exclude and assess any associated obscured breast lesions, as it is good in delineating breast masses obscured by condensed parenchymal tissue. The calculated sensitivity of DM & CEDM was 87.5%, 95.8%, specificity was 55.5%, 72%, the PPV and NPV were 91, 93.6% and 45%, 77.8%, respectively.ConclusionsCEDM has an important additional diagnostic value in the assessment, characterization and better delineation of breast lesions in primary edematous breast cases.
Highlights
Primary breast edema can cause marked increase in skin thickness, breast density and echogenicity due to dense breast tissue filled with fluid and so causes subsequent significant attenuation of both the x-ray and ultrasound beams
We aim to assess the contrast-enhanced digital mammography role in cases associated with primary breast edema and how it can help in detection and characterization of lesions
We correlated most breast lesions and pathological axillary lymph nodes with pathological results using surgery, excisional biopsy, skin punch biopsy, true cut biopsy, or fine needle aspiration cytology
Summary
Primary breast edema can cause marked increase in skin thickness, breast density and echogenicity due to dense breast tissue filled with fluid and so causes subsequent significant attenuation of both the x-ray and ultrasound beams. The study aim is to assess the value of contrast-enhanced digital mammography (CEDM) in assessment and characterization of the obscured underlying breast lesions in cases of primary breast edema. Breast edema in inflammatory breast cancer can cause tremendous skin thickening and breast enlargement that attenuates both the x-ray and Contrast-enhanced digital mammography (CEDM) had a better diagnostic accuracy mainly due to improved specificity, and better positive and negative predictive values. CEDM could be useful in some cases demonstrating clinical or ultrasono-graphic abnormality with no obvious findings at mammography It is the case in dense breasts where normal breast tissue can hide a cancer [5]
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