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  • Contrast-enhanced...

Contrast-enhanced mammography may substitute Breast MRI for preoperative staging of invasive lobular cancer

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-05-22T09:30:20+05:30  |  Updated On 22 May 2023 4:16 PM IST
Contrast-enhanced mammography may substitute Breast MRI for    preoperative staging of invasive lobular cancer
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New research found that contrast-enhanced mammography (CEM) can be an alternative to breast MRI for preoperative staging of invasive lobular carcinoma (ILC). As with equal systematic and random errors, both CEM and MRI overstate ILC size. Also as the sensitivity of MRI for identification of multifocal/contralateral tumors increased, associated specificity has decreased. Hence CEM can replace MRI for ILC of the breast. The study results were published in the European Journal of Radiology.

The best modality for preoperative staging of invasive lobular carcinoma (ILC) is an MRI of the breast. Contrast-enhanced mammography (CEM) has equivalent diagnostic performance to MRI, however, evidence of CEM's accuracy in women diagnosed with ILC is limited. Hence Dr. Marc Lobbes, Ph.D., from Maastricht University in the Netherlands, and the team conducted a study to understand the accuracy of CEM and MRI in preoperative ILC staging.

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Between 013 and 2021, tumor diameter was extracted from all the gathered ILC cases for both modalities from the reports. Discrepancies between size measurements were assessed using the Bland-Altman plots as per the imaging and histopathological findings. Sensitivity, specificity, and diagnostic odds ratios (DORs) were used to express the CEM and MRI’s ability to detect multifocal/contralateral cancers. There were no pairwise comparisons of women undergoing both CEM and MRI.

Key findings:

  • 305 ILC cases with a mean age of 63.7 years were included in the study.
  • The preoperative staging was performed using MRI or CEM in 266 (87.2%) and 77 (25.2%) cases, respectively.
  • Both MRI and CEM overestimated tumor size by 1.5 and 2.1 mm, respectively.
  • MRI reported more Sensitivity to detect multifocal disease than CEM (86% versus 78%), but specificity was lower for MRI (79% versus 92%).
  • For the detection of contralateral breast cancer, sensitivity for MRI was 96% versus 88% for CEM, and specificity was 92% and 99%, respectively.
  • For both indications, DOR was higher for CEM, but the differences were non-significant (p = 0.56 and p = 0.78).
Also Read: Fluorescent guide can help detect tumours left behind following breast cancer surgery: NEJM

Thus, though the discriminative ability for both modalities was non-significant, CEM can be an alternative to breast MRI.

Further reading: Lobbes MBI, Neeter LMFH, Raat F, et al. The performance of contrast-enhanced mammography and breast MRI in local preoperative staging of invasive lobular breast cancer [published online ahead of print, 2023 May 13]. Eur J Radiol. 2023;164:110881. doi: 10.1016/j.ejrad.2023.110881

European Journal of RadiologyRadiologyCancer diagnosisMammographyMRI
Source : European Journal of Radiology
Dr.Niharika Harsha B
Dr.Niharika Harsha B

    BDS, MDS

    Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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