I P L Houben1, P Van de Voorde2, C R L P N Jeukens1, J E Wildberger3, L F Kooreman4, M L Smidt5, M B I Lobbes6. 1. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands. 2. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. 3. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands. 4. Department of Pathology, Maastricht University Medical Center, Maastricht, The Netherlands. 5. Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands. 6. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address: marc.lobbes@mumc.nl.
Abstract
OBJECTIVE: Contrast-enhanced spectral mammography (CESM) is a reliable problem solving tool in the work-up of women recalled from breast cancer screening. We evaluated additional findings caused by CESM alone and outweighed them against the disadvantages of this technique. METHODS: From December 2012 to December 2015, all women recalled from screening who underwent CESM were considered for this study. Radiation exposure and number of adverse contrast reactions were analysed. An experienced breast radiologist reviewed all exams and identified cases with lesions detected by CESM alone and scored their conspicuity. From these cases, data on breast density and final diagnosis were collected. For malignant cases, tumour grade and receptor characteristics were also collected. RESULTS: During this study, 839 women underwent CESM after a screening recall, in which five minor adverse contrast reactions were observed. Median radiation dose per exam was 6.0mGy (0.9-23.4mGy). Seventy CESM-only lesions were detected in 65 patients. Of these 70 lesions, 54.3% proved to be malignant, most commonly invasive ductal carcinomas. The remaining CESM-only lesions were benign, predominantly fibroadenomas. No complications were observed during biopsy of these lesions. Retrospectively, the majority of the lesions were either occult or a 'minimal sign' on low-energy CESM images or the screening mammogram. CONCLUSION: Using CESM as a work-up tool for women recalled from screening carries low risk for the patient, while additionally detected tumour foci might hold important clinical implications which need to be further studied in large, randomized controlled trials.
OBJECTIVE: Contrast-enhanced spectral mammography (CESM) is a reliable problem solving tool in the work-up of women recalled from breast cancer screening. We evaluated additional findings caused by CESM alone and outweighed them against the disadvantages of this technique. METHODS: From December 2012 to December 2015, all women recalled from screening who underwent CESM were considered for this study. Radiation exposure and number of adverse contrast reactions were analysed. An experienced breast radiologist reviewed all exams and identified cases with lesions detected by CESM alone and scored their conspicuity. From these cases, data on breast density and final diagnosis were collected. For malignant cases, tumour grade and receptor characteristics were also collected. RESULTS: During this study, 839 women underwent CESM after a screening recall, in which five minor adverse contrast reactions were observed. Median radiation dose per exam was 6.0mGy (0.9-23.4mGy). Seventy CESM-only lesions were detected in 65 patients. Of these 70 lesions, 54.3% proved to be malignant, most commonly invasive ductal carcinomas. The remaining CESM-only lesions were benign, predominantly fibroadenomas. No complications were observed during biopsy of these lesions. Retrospectively, the majority of the lesions were either occult or a 'minimal sign' on low-energy CESM images or the screening mammogram. CONCLUSION: Using CESM as a work-up tool for women recalled from screening carries low risk for the patient, while additionally detected tumour foci might hold important clinical implications which need to be further studied in large, randomized controlled trials.
Authors: María Del Mar Travieso-Aja; Daniel Maldonado-Saluzzi; Pedro Naranjo-Santana; Claudia Fernández-Ruiz; Wilsa Severino-Rondón; Mario Rodríguez Rodríguez; Víctor Vega Benítez; Octavio Pérez-Luzardo Journal: Radiol Med Date: 2019-06-27 Impact factor: 3.469
Authors: Andrea Cozzi; Simone Schiaffino; Marianna Fanizza; Veronica Magni; Laura Menicagli; Cristian Giuseppe Monaco; Adrienn Benedek; Diana Spinelli; Giovanni Di Leo; Giuseppe Di Giulio; Francesco Sardanelli Journal: Eur Radiol Date: 2022-06-01 Impact factor: 7.034
Authors: M B I Lobbes; J Hecker; I P L Houben; R Pluymakers; C Jeukens; U C Laji; S Gommers; J E Wildberger; P J Nelemans Journal: Eur Radiol Date: 2019-05-09 Impact factor: 5.315
Authors: L M F H Neeter; I P L Houben; P J Nelemans; T J A Van Nijnatten; R M Pijnappel; C Frotscher; M Osinga-de Jong; F Sanders; T Van Dalen; H P J Raat; B A B Essers; J E Wildberger; M L Smidt; M B I Lobbes Journal: Trials Date: 2019-12-23 Impact factor: 2.279