The additive value of 3D automated breast ultrasound and contrast enhanced spectral mammography in the assessment of suspicious breast lesions.

Abstract

Background: Worldwide, breast cancer is the most commonly diagnosed cancer among women accounting for over a million cases each year. Mammography still remains the gold standard for early detection of breast cancer. Contrast Enhanced Spectral Mammography (CESM) allows better estimation of the lesion size and detection of multifocal breast cancers. Automated breast ultrasound (ABUS) is an innovation of breast ultrasound that attains 3-D images of the entire breast overcoming the limitations of hand-held ultrasound. The aim is to evaluate the impact of 3D ABUS in correlation with CESM on the characterization and assessment of disease extent.

Design & population: The study was performed at the Female Imaging Unit of the National Cancer Institute (NCI), Cairo University and in Baheya Foundation. One hundred and six patients were randomly chosen out of patients who were initially given BIRADS IV - V by standard mammography. The contrast enhanced digital mammography and 3D automated ultrasound data were evaluated by two experienced radiologists; both observers were blinded to the pathological data of each patient.

Results: Regarding primary outcome of our study in assessment of tumor size, extension and multiplicity, the use of ABUS after CESM showed significant increase in the sensitivity of the test (80% for combined test versus 40% for CESM alone), while it showed almost no significant difference in specificity (70% for CESM and Combined tests).The ABUS also showed more accuracy in detection of suspicious lesions (61%) than the CESM (40%.) CONCLUSION: ABUS is considered a revolution in breast scanning by ultrasound imaging that can be used as a non-invasive complementary tool to CESM in assessment of suspicious breast lesions showing increased accuracy of study and patient outcome upon combing both of them.