Role of contrast enhanced mammography in diagnosis of malignant breast lesion with histopathological correlation

Abstract

Abstract Background Contrast-enhanced spectral mammography (CESM) is a relatively new tool in breast imaging, which combines the benefits of full field digital mammography (FFDM) with intravenous contrast utilization. FFDM alone is a two-dimensional modality in which summation of overlapping tissues accounts for false-negative and false-positive findings, resulting in increased recall rates and limited sensitivity of the examination, especially in the setting of heterogeneously dense or extremely dense breast tissue. CESM advantageously uses the concept of angiogenesis in tumors by allowing contrast agents to highlight the areas of blood vessel proliferation relative to the surrounding normal breast tissue (Bhimani et al, 2017). Objectives The purpose of this study is to assess the role of contrast-enhanced (CEM) mammography for detecting malignant lesions compared to histopathological results. Methods A cross sectional study including 35 patients suspecting breast mass clinically, concluded at Ain Shams University hospitals, Radiology Department, in the outpatient breast clinic, the patients were investigated using SenoBright spectral mammography device, the period between January 2018 till the end of b June 2019. Results In our study CESM had a sensitivity of 95.7 %, a specificity of 66.7 %, a positive predictive value of 84.6% (PPV), a negative predictive value of 88.9 % (NPV) and efficacy 85.7 %. Conclusions CESM has better diagnostic performance than the standard conventional imaging; mammography plus ultrasound and provides a valuable tool to evaluate equivocal and suspicious breast lesions and detect multifocal/multicenteric disease accurately.