Comparison of the efficacy of contrast-enhanced mammography as an adjunct to the combination of full-field digital mammography, digital breast tomosynthesis and ultrasound in the assessment of the indeterminate breast lesions

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Objectives: The study aimed to compare the efficacy of contrast-enhanced mammography as an adjunct to the combination of full-field digital mammography and ultrasound in the assessment of the indeterminate breast lesions with histopathology as the gold standard. A subgroup analysis was also performed in patients with dense breasts. Material and Methods: Forty-three women with 47 indeterminate breast lesions (BIRADS 4A) on full-field digital mammography (FFDM) and ultrasound (US) underwent dual-energy contrast-enhanced spectral mammography (CESM). Results were compared with histopathology findings and analysed. Statistical analysis- The results were analysed using descriptive statistics and comparisons among the various groups. Discrete (categorical) data were summarised in proportions and percentages (%) and frequency analysis. McNemar test, Chi-square test, and other appropriate tests were used to find associations and relations. For the mean + standard deviation at 95% confidence interval Mann- Whitney test was used. Results: CESM demonstrated sensitivity, specificity, positive preditive value (PPV), negative predictive value (NPV), false-positive rate, and diagnostic accuracy of 91.25%, 90.7%, 90.02%, 94.01%, 8.6%, and 92.3%, respectively. In contrast, FFDM+ USG combination showed values of 83.32%, 81.6%, 73.5%, 82.4%, 9.8%, and 86.6%, respectively. In high-density breasts, sensitivity, specificity, PPV, NPV, false-positive rate, and diagnostic accuracy of CESM were 93.7%, 91.7% %, 89.9%, 92.8% %, 9.2%, and 94.1%, respectively. In contrast, FFDM + USG combination showed values of 76.58%, 72.34%, 68.34%, 72.4%, 11.2%, and 78.3%, respectively. Conclusion: CESM provides superior diagnostic performance over FFDM and USG, particularly in indeterminate lesions. It is especially valuable in dense breasts, offering a reliable, cost-effective alternative to MRI.