The contribution of contrast-enhanced spectral mammography in detecting breast carcinoma of dense breasts

Abstract

Objective To assess the contribution of contrast-enhanced spectral mammography (CESM) in detecting breast carcinoma of dense breasts. Methods To retrospectively analyze the imaging and clinical data of 52 female patients with breast carcinoma which were confirmed by pathology in Tai′an Central Hospital of Shandong Province from April 2017 to April 2018.All cases classified as dense or uneven dense breasts by DM examination underwent Ultrasound (US), digital mammography (DM), CESM, dynamic contrast enhanced MRI (DCE-MRI).The breast imaging report and data system (BI-RADS) and breast density classification were both evaluated using the 5th edition of BI-RADS. The efficacy of US, DM, DM+CESM, DCE-MRI in detecting breast carcinoma (BI-RADS 5) was evaluated by χ2 test. Results Histopathology confirmed that 87 lesions were malignant and 35 lesions were benign. The sensitivity of US, DM, DM + CESM, DCE-MRI were 66.67%(58/87), 64.37%(56/87), 100.00%(87/87), 100.00%(87/87) and the specificity were 94.28%(33/35), 74.28%(26/35), 85.71%(30/35), 51.43%(18/35), respectively. There was statistically significant difference in specificity (χ2=9.545, P=0.002) and BI-RADS 5 category, detection 39.08%(34/87), 22.99%(20/87), respectively (χ2=5.263, P=0.022) between the DM + CESM group and DCE-MRI group. Conclusion In dense breasts, CESM has a high application value in breast carcinoma diagnosis. Key words: Breast neoplasms; Contrast enhanced spectral mammography; Dense breast; Dynamic contrast enhanced magnetic resonance imaging