Contrast-enhanced mammography in the management of breast architectural distortions and avoidance of unnecessary biopsies.

IF 4 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Cancer Pub Date : 2024-09-01 Epub Date: 2024-05-29 DOI:10.1007/s12282-024-01599-x

Chiara Bellini, Francesca Pugliese, Giulia Bicchierai, Francesco Amato, Diego De Benedetto, Federica Di Naro, Cecilia Boeri, Ermanno Vanzi, Giuliano Migliaro, Ludovica Incardona, Cinzia Tommasi, Lorenzo Orzalesi, Vittorio Miele, Jacopo Nori

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引用次数: 0

Abstract

Background: To assess contrast-enhanced mammography (CEM) in the management of BI-RADS3 breast architectural distortions (AD) in digital breast tomosynthesis (DBT).

Methods: We retrospectively reviewed 328 women with 332 ADs detected on DBT between 2017 and 2021 and selected those classified as BI-RADS3 receiving CEM as problem-solving. In CEM recombined images, we evaluated AD's contrast enhancement (CE) according to its presence/absence, type, and size. AD with enhancement underwent imaging-guided biopsy while AD without enhancement follow-up or biopsy if detected in high/intermediate-risk women.

Results: AD with enhancement were 174 (52.4%): 72 (41.4%) were malignant lesions, 102 (59.6%) false positive results: 28 (16%) B3 lesions, and 74 (42.5%) benign lesions. AD without enhancement were 158 (47.6%): 26 (16.5%) were subjected to biopsy (1 malignant and 25 benign) while the other 132 cases were sent to imaging follow-up, still negative after two years. CEM's sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and accuracy were 98.63%, 60.62%, 41.38%, 99.37%, and 68.98%. The AUC determined by ROC was 0.796 (95% CI, 0.749-0.844).

Conclusion: CEM has high sensitivity and NPV in evaluating BI-RADS3 AD and can be a complementary tool in assessing AD, avoiding unnecessary biopsies without compromising cancer detection.

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对比增强乳腺 X 射线照相术在处理乳房结构变形和避免不必要的活组织检查中的应用。

背景：评估对比增强乳腺X线摄影（CEM）在数字乳腺断层合成术（DBT）中处理BI-RADS3乳腺结构变形（AD）的效果：目的：评估造影剂增强乳腺摄影（CEM）在数字乳腺断层合成术（DBT）中处理BI-RADS3乳腺结构变形（AD）的情况：我们回顾性地查看了2017年至2021年间328名女性在DBT中检测到的332个AD，并选择被归类为BI-RADS3的女性接受CEM作为问题解决方案。在CEM重组图像中，我们根据AD的有/无、类型和大小评估其对比度增强（CE）。如果在高危/中危妇女中发现有增强的 AD，则在成像引导下进行活检；如果发现无增强的 AD，则进行随访或活检：结果：有增强的 AD 为 174 例（52.4%）：72例（41.4%）为恶性病变，102例（59.6%）为假阳性结果：28例（16%）为B3病变，74例（42.5%）为良性病变。无强化的 AD 为 158 例（47.6%）：26 例（16.5%）进行了活检（1 例为恶性，25 例为良性），其他 132 例进行了影像学随访，两年后仍为阴性。CEM的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）以及准确性分别为98.63%、60.62%、41.38%、99.37%和68.98%。ROC得出的AUC为0.796（95% CI，0.749-0.844）：CEM在评估BI-RADS3 AD方面具有较高的灵敏度和NPV，可作为评估AD的辅助工具，在不影响癌症检测的情况下避免不必要的活检。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer ONCOLOGY-OBSTETRICS & GYNECOLOGY

CiteScore

6.70

自引率

2.50%

发文量

105

审稿时长

6-12 weeks

期刊介绍： Breast Cancer, the official journal of the Japanese Breast Cancer Society, publishes articles that contribute to progress in the field, in basic or translational research and also in clinical research, seeking to develop a new focus and new perspectives for all who are concerned with breast cancer. The journal welcomes all original articles describing clinical and epidemiological studies and laboratory investigations regarding breast cancer and related diseases. The journal will consider five types of articles: editorials, review articles, original articles, case reports, and rapid communications. Although editorials and review articles will principally be solicited by the editors, they can also be submitted for peer review, as in the case of original articles. The journal provides the best of up-to-date information on breast cancer, presenting readers with high-impact, original work focusing on pivotal issues.