Prediction of Underestimation Using Contrast-Enhanced Spectral Mammography in Patients Diagnosed as Ductal Carcinoma In Situ on Preoperative Core Biopsy

Copyright © 2021 Elsevier Inc. All rights reserved..

BACKGROUND: To assess the performance of contrast-enhanced spectral mammography (CESM) for the prediction of DCIS underestimation in comparison with mammography, breast US, and breast MRI.

PATIENTS AND METHODS: We prospectively enrolled patients diagnosed with DCIS on preoperative core biopsy. Visibility, lesion type, and extent on each imaging modality, CESM gray values (CGV) were evaluated. Pathologic features of core biopsy and surgery were recorded. Chi-square or Fisher's exact test were used for univariate analysis. Multivariate logistic regression analysis was used to find independent predictors for DCIS underestimation and receiver operating characteristic (ROC) curve analysis was performed.

RESULTS: A total of 113 lesions in 108 patients were analyzed (50 pure DCIS; 63 underestimated DCIS). Visibility on mammography, breast US, CESM, and breast MRI were 44%, 76%, 58%, and 80% for pure DCIS, and 73%, 81%, 86%, and 92% for underestimated DCIS. Tumor extents on surgical pathology of pure and underestimated DCIS were 1.11 ± 1.35 cm and 2.61 ± 2.09 cm. On multivariate analysis, nuclear grade and suspected invasion on core biopsy, visibility on mammography, and extent on breast MRI were independent factors for the model 1, whereas nuclear grade on core biopsy, extent on CESM, and mean CGV on MLO-recombined image were independent factors for the model 2. Area under ROC curve (AUC) was 0.843 for model 1 including breast MRI, whereas AUC was 0.823 for model 2 including CESM, which didn't show a significant difference (P = .968).

CONCLUSION: For detecting underestimated DCIS, CESM was superior to mammography and breast US, and comparable to breast MRI.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:22

Enthalten in:

Clinical breast cancer - 22(2022), 3 vom: 13. Apr., Seite e374-e386

Sprache:

Englisch

Beteiligte Personen:

Shin, Hee Jung [VerfasserIn]
Choi, Woo Jung [VerfasserIn]
Park, Seo Young [VerfasserIn]
Ahn, Sei Hyun [VerfasserIn]
Son, Byung Ho [VerfasserIn]
Chung, Il Yong [VerfasserIn]
Lee, Jong Won [VerfasserIn]
Ko, Beom Seok [VerfasserIn]
Kim, Ji Sun [VerfasserIn]
Chae, Eun Young [VerfasserIn]
Cha, Joo Hee [VerfasserIn]
Kim, Hak Hee [VerfasserIn]

Links:

Volltext

Themen:

Breast cancer
Contrast-enhanced spectral mammography
Ductal carcinoma in situ
Journal Article
Research Support, Non-U.S. Gov't
Underestimation

Anmerkungen:

Date Completed 02.05.2022

Date Revised 02.05.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.clbc.2021.10.004

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM333141172