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Pandit P, Murkey SP, Agarwal A, Jaiswal A, Agrawal S. Understanding Fibroadenoma of the Breast: A Comprehensive Review of Pre-operative and Post-operative Clinicopathological Correlations. Cureus 2023; 15:e51329. [PMID: 38288219 PMCID: PMC10823311 DOI: 10.7759/cureus.51329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/30/2023] [Indexed: 01/31/2024] Open
Abstract
Fibroadenomas of the breast are common benign lesions that predominantly affect young women. This review provides a comprehensive overview of fibroadenoma management, encompassing their definition, clinical presentation, diagnostic tools, surgical management, clinicopathological correlations, treatment outcomes, complications, and emerging research. Fibroadenomas typically present as palpable breast lumps, often with no associated nipple discharge, and their diagnosis relies on a combination of clinical examination, breast imaging, and pathological confirmation. Surgical interventions, including excisional biopsy and lumpectomy, offer symptom relief and favorable long-term outcomes. Minimally invasive techniques and ongoing research into genomics and molecular aspects hold promise for the future of fibroadenoma management. Multidisciplinary collaboration among healthcare providers is paramount, ensuring accurate diagnosis, personalized treatment decisions, and holistic patient care. As research advances, the management of fibroadenomas is poised to evolve, providing improved diagnostic accuracy, minimally invasive treatments, and enhanced patient outcomes.
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Affiliation(s)
- Pranam Pandit
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Siddhant P Murkey
- Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Akash Agarwal
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Arpita Jaiswal
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Suyash Agrawal
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Basurto-Hurtado JA, Cruz-Albarran IA, Toledano-Ayala M, Ibarra-Manzano MA, Morales-Hernandez LA, Perez-Ramirez CA. Diagnostic Strategies for Breast Cancer Detection: From Image Generation to Classification Strategies Using Artificial Intelligence Algorithms. Cancers (Basel) 2022; 14:3442. [PMID: 35884503 PMCID: PMC9322973 DOI: 10.3390/cancers14143442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/02/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023] Open
Abstract
Breast cancer is one the main death causes for women worldwide, as 16% of the diagnosed malignant lesions worldwide are its consequence. In this sense, it is of paramount importance to diagnose these lesions in the earliest stage possible, in order to have the highest chances of survival. While there are several works that present selected topics in this area, none of them present a complete panorama, that is, from the image generation to its interpretation. This work presents a comprehensive state-of-the-art review of the image generation and processing techniques to detect Breast Cancer, where potential candidates for the image generation and processing are presented and discussed. Novel methodologies should consider the adroit integration of artificial intelligence-concepts and the categorical data to generate modern alternatives that can have the accuracy, precision and reliability expected to mitigate the misclassifications.
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Affiliation(s)
- Jesus A. Basurto-Hurtado
- C.A. Mecatrónica, Facultad de Ingeniería, Campus San Juan del Río, Universidad Autónoma de Querétaro, Rio Moctezuma 249, San Cayetano, San Juan del Rio 76807, Mexico; (J.A.B.-H.); (I.A.C.-A.)
- Laboratorio de Dispositivos Médicos, Facultad de Ingeniería, Universidad Autónoma de Querétaro, Carretera a Chichimequillas S/N, Ejido Bolaños, Santiago de Querétaro 76140, Mexico
| | - Irving A. Cruz-Albarran
- C.A. Mecatrónica, Facultad de Ingeniería, Campus San Juan del Río, Universidad Autónoma de Querétaro, Rio Moctezuma 249, San Cayetano, San Juan del Rio 76807, Mexico; (J.A.B.-H.); (I.A.C.-A.)
- Laboratorio de Dispositivos Médicos, Facultad de Ingeniería, Universidad Autónoma de Querétaro, Carretera a Chichimequillas S/N, Ejido Bolaños, Santiago de Querétaro 76140, Mexico
| | - Manuel Toledano-Ayala
- División de Investigación y Posgrado de la Facultad de Ingeniería (DIPFI), Universidad Autónoma de Querétaro, Cerro de las Campanas S/N Las Campanas, Santiago de Querétaro 76010, Mexico;
| | - Mario Alberto Ibarra-Manzano
- Laboratorio de Procesamiento Digital de Señales, Departamento de Ingeniería Electrónica, Division de Ingenierias Campus Irapuato-Salamanca (DICIS), Universidad de Guanajuato, Carretera Salamanca-Valle de Santiago KM. 3.5 + 1.8 Km., Salamanca 36885, Mexico;
| | - Luis A. Morales-Hernandez
- C.A. Mecatrónica, Facultad de Ingeniería, Campus San Juan del Río, Universidad Autónoma de Querétaro, Rio Moctezuma 249, San Cayetano, San Juan del Rio 76807, Mexico; (J.A.B.-H.); (I.A.C.-A.)
| | - Carlos A. Perez-Ramirez
- Laboratorio de Dispositivos Médicos, Facultad de Ingeniería, Universidad Autónoma de Querétaro, Carretera a Chichimequillas S/N, Ejido Bolaños, Santiago de Querétaro 76140, Mexico
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Lorek A, Steinhof-Radwańska K, Barczyk-Gutkowska A, Zarębski W, Paleń P, Szyluk K, Lorek J, Grażyńska A, Niemiec P, Gisterek I. The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment-Analysis of 999 Patients with Primary Operable Breast Cancer. ACTA ACUST UNITED AC 2021; 28:2548-2559. [PMID: 34287253 PMCID: PMC8293137 DOI: 10.3390/curroncol28040232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/01/2021] [Accepted: 07/09/2021] [Indexed: 12/20/2022]
Abstract
Contrast-enhanced spectral mammography (CESM) is a promising, digital breast imaging method for planning surgeries. The study aimed at comparing digital mammography (MG) with CESM as predictive factors in visualizing multifocal-multicentric cancers (MFMCC) before determining the surgery extent. We analyzed 999 patients after breast cancer surgery to compare MG and CESM in terms of detecting MFMCC. Moreover, these procedures were assessed for their conformity with postoperative histopathology (HP), calculating their sensitivity and specificity. The question was which histopathological types of breast cancer were more frequently characterized by multifocality–multicentrality in comparable techniques as regards the general number of HP-identified cancers. The analysis involved the frequency of post-CESM changes in the extent of planned surgeries. In the present study, MG revealed 48 (4.80%) while CESM 170 (17.02%) MFMCC lesions, subsequently confirmed in HP. MG had MFMCC detecting sensitivity of 38.51%, specificity 99.01%, PPV (positive predictive value) 85.71%, and NPV (negative predictive value) 84.52%. The respective values for CESM were 87.63%, 94.90%, 80.57% and 96.95%. Moreover, no statistically significant differences were found between lobular and NST cancers (27.78% vs. 21.24%) regarding MFMCC. A treatment change was required by 20.00% of the patients from breast-conserving to mastectomy, upon visualizing MFMCC in CESM. In conclusion, mammography offers insufficient diagnostic sensitivity for detecting additional cancer foci. The high diagnostic sensitivity of CESM effectively assesses breast cancer multifocality/multicentrality and significantly changes the extent of planned surgeries. The multifocality/multicentrality concerned carcinoma, lobular and invasive carcinoma of no special type (NST) cancers with similar incidence rates, which requires further confirmation.
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Affiliation(s)
- Andrzej Lorek
- Department of Oncological Surgery, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-514 Katowice, Poland;
- Correspondence: (A.L.); (K.S.-R.)
| | - Katarzyna Steinhof-Radwańska
- Department of Radiology and Nuclear Medicine, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-514 Katowice, Poland;
- Correspondence: (A.L.); (K.S.-R.)
| | - Anna Barczyk-Gutkowska
- Department of Radiology and Nuclear Medicine, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-514 Katowice, Poland;
| | - Wojciech Zarębski
- Department of Oncological Surgery, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-514 Katowice, Poland;
| | - Piotr Paleń
- Department of Pathomorphology and Molecular Diagnostics, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Karol Szyluk
- Department of Orthopaedic and Trauma Surgery, District Hospital of Orthopaedics and Trauma Surgery, 41-940 Piekary Śląskie, Poland;
| | - Joanna Lorek
- Department of Surgery, Ludwig Rydygier Hospital sp. z.o.o., 31-826 Kraków, Poland;
| | - Anna Grażyńska
- Students’ Scientific Society, Department of Radiology and Nuclear Medicine, Medical University of Silesia, 40-514 Katowice, Poland;
| | - Paweł Niemiec
- Department of Biochemistry and Medical Genetics, School of Health Sciences, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Iwona Gisterek
- Department of Oncology and Radiotherapy, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-514 Katowice, Poland;
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Lorek A, Steinhof-Radwańska K, Barczyk-Gutkowska A, Zarębski W, Boratyn-Nowicka A, Bobola A, Lorek J, Stojčev Z. Retrospective Comparison of Contrast-Enhanced Spectral Mammography with Digital Mammography in Assessing Tumor Size in 668 Cases of Breast Cancer. Med Sci Monit 2020; 26:e926977. [PMID: 32994388 PMCID: PMC7534504 DOI: 10.12659/msm.926977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Contrast-enhanced spectral mammography (CESM) is digital mammography with contrast agent. This promising new breast imaging method can be used for planning surgical treatment. This study compared CESM versus digital mammography (MG) in evaluating tumor size in breast cancer. Material/Methods Comparison of tumor dimensions in CESM, MG, and histopathology was made. The correlation of these data was assessed by histopathological type, biological subtype, grading of the carcinoma, and patient age. Results The average difference in tumor size between CESM and histopathological examination was 5 mm. The differences in size measurement between CESM and MG were significant (p=0.00). The Pearson’s linear correlation coefficients of CESM versus HP and MG versus HP were −0.01 (p=0.79) and −0.25 (p=0.00), respectively, indicating no differences between CESM and HP based on the lesion size. A weak negative correlation between those values was observed on MG. No relationship was found between the tumor size in CESM and the biological subtype, carcinoma malignancy degree, or patient age. Conclusions CESM is a new diagnostic method in breast cancer. The accuracy of measurement of tumor size using CESM is independent of lesion size, but it overestimates the size by 5 mm on average. The difference is not dependent on grading, biological subtype of the carcinoma, or patient age. They concern the histopathological type, and values are significantly greater in pre-invasive carcinomas.
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Affiliation(s)
- Andrzej Lorek
- Department of Oncological Surgery, Medical University of Silesia in Katowice, Katowice, Poland
| | | | - Anna Barczyk-Gutkowska
- Department of Radiology and Nuclear Medicine, Medical University of Silesia in Katowice, Katowice, Poland
| | - Wojciech Zarębski
- Department of Oncological Surgery, Medical University of Silesia in Katowice, Katowice, Poland
| | | | - Agnieszka Bobola
- Department of Oncology, Medical University of Silesia in Katowice, Katowice, Poland
| | - Joanna Lorek
- Student of the Medical Faculty at the Medical University of Silesia in Katowice, Katowice, Poland
| | - Zoran Stojčev
- Department of Oncological Surgery, Medical University of Silesia in Katowice, Katowice, Poland
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Zhang Y, Qi J, Li J, Jia S, Wang Y, Sun Q, Kang Y, Liu Y, Cao Y, Yu J. Utility of Circulating Tumor Cells for Detection of Early-Stage Luminal A Breast Cancer. Am J Med Sci 2020; 360:543-551. [PMID: 32690274 DOI: 10.1016/j.amjms.2020.01.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 12/09/2019] [Accepted: 01/24/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Patients with early-stage luminal A breast cancer (LABC) have better prognoses. However, follow-up examinations are frequent and remain complex. The present study examined whether circulating tumor cell (CTC) detection could be used as an earlier and more reproducible indicator of disease status among patients with early-stage LABC, and given China's healthcare resource challenges, whether it could periodically replace follow-up routine imaging. METHODS A total of 135 postoperative Chinese patients with early-stage LABC were randomly assigned to a CTC group (68 patients underwent alternating assessments using CTC detection and routine re-examination) or control group (67 patients underwent only routine re-examination). The prognosis and patient-covered costs of the various assessments were calculated for the 2 groups. RESULTS No patients had normal CTCs and simultaneous abnormal imaging findings. There were no differences in overall survival, disease-free survival and total patient-covered cost of follow-up between the 2 groups (all P > 0.05). However, there was a significant difference in the average patient-covered cost (P < 0.001). Furthermore, significant intergroup differences were observed in the total and average hospitalization times (P < 0.05). CONCLUSIONS Among Chinese patients with low-risk LABC, CTC detection was highly reliable and relatively low cost. Therefore, CTC detection may be used to reduce the number of routine imaging follow-ups.
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Affiliation(s)
- Yang Zhang
- Department of Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Ji Qi
- School of Epidemiology, China Medical University, Shenyang, Liaoning Province, China
| | - Jianyi Li
- Department of Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
| | - Shi Jia
- Department of Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yitong Wang
- Department of Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Qiang Sun
- Department of Breast Surgery, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, Liaoning Province, China
| | - Ye Kang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yushi Liu
- School of Clinical Medicine, China Medical University, Shenyang, Liaoning Province, China
| | - Yanan Cao
- School of Clinical Medicine, China Medical University, Shenyang, Liaoning Province, China
| | - Jiaxin Yu
- School of Clinical Medicine, Jinzhou Medical University, Jinzhou, Liaoning Province, China
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Yasin R, El Ghany EA. BIRADS 4 breast lesions: comparison of contrast-enhanced spectral mammography and contrast-enhanced MRI. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0043-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Breast cancer is the most common cancer in women worldwide. It is responsible for about 23% of cancer in females in both developed and developing countries [1]. We aimed to assess the accuracy of contrast-enhanced spectral mammography (CESM) versus contrast-enhanced breast MRI in the evaluation of BIRADS 4 breast lesions.
Results
Fifty patients were included in this study; there were 28 malignant cases and 22 benign cases; all cases were proved by histopathological result either by core biopsy or excision biopsy. CESM was found to have less sensitivity (94.1%) than MRI (100%) but CESM has higher specificity (100%) than MRI (95.5%). The accuracy of CESM was 96.4%, while the accuracy of MRI was 98.2% with no statistical significance (P value 0.827).
Conclusion
CESM can be used as a sensitive diagnostic tool in the detection and staging of breast cancer with higher specificity and less sensitivity as compared to contrast enhanced breast MRI.
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Contrast-Enhanced Spectral Mammography in Women With Intermediate Breast Cancer Risk and Dense Breasts. AJR Am J Roentgenol 2018; 211:W267-W274. [DOI: 10.2214/ajr.17.19355] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Kan-Dapaah K, Rahbar N, Soboyejo W. Polymeric composite devices for localized treatment of early-stage breast cancer. PLoS One 2017; 12:e0172542. [PMID: 28245288 PMCID: PMC5330467 DOI: 10.1371/journal.pone.0172542] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 02/06/2017] [Indexed: 02/03/2023] Open
Abstract
For early-stage breast cancers mastectomy is an aggressive form of treatment. Therefore, there is a need for new treatment strategies that can enhance the use of lumpectomy by eliminating residual cancer cells with limited side effects to reduce local recurrence. Although, various radiotherapy-based methods have been developed, residual cells are found in 20–55% of the time at the first operation. Furthermore, some current treatment methods result in poor cosmesis. For the last decade, the authors have been exploring the use of polymeric composite materials in single and multi-modal implantable biomedical devices for post-operative treatment of breast cancer. In this paper, the concept and working principles of the devices, as well as selected results from experimental and numerical investigations, are presented. The results show the potential of the biomedical implants for cancer treatment.
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Affiliation(s)
- Kwabena Kan-Dapaah
- Department of Biomedical Engineering, University of Ghana, Accra, Greater Accra, Ghana
| | - Nima Rahbar
- Department of Civil and Environmental Engineering, Worcester Polytechnic Institute (WPI), Worcester, MA, United States of America
| | - Wole Soboyejo
- Department of Mechanical and Aerospace Engineering, Princeton University, Princeton, NJ, United States of America.,Princeton Institute for Science and Technology of Materials (PRISM), Princeton University, Princeton, NJ, United States of America.,Department of Mechanical Engineering, Worcester Polytechnic Institute (WPI), Worcester Polytechnic Institute, Worcester, MA, United States of America.,Department of Biomedical Engineering, Worcester Polytechnic Institute (WPI), Worcester, MA, United States of America
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Wang Q, Li K, Wang L, Zhang J, Zhou Z, Feng Y. Preclinical study of diagnostic performances of contrast-enhanced spectral mammography versus MRI for breast diseases in China. SPRINGERPLUS 2016; 5:763. [PMID: 27386249 PMCID: PMC4912545 DOI: 10.1186/s40064-016-2385-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 05/23/2016] [Indexed: 12/22/2022]
Abstract
Purpose To evaluate diagnostic performances of CESM for breast diseases with comparison to breast MRI in China. Materials and methods Sixty-eight patients with 77 breast lesions underwent MR and CESM. Two radiologists interpreted either MRI or CESM images, separately and independently. BI-RADS 1–3 and BI-RADS 4–5 were classified into the suspicious benign and suspicious malignant groups. Diagnostic accuracy parameters were calculated. Receiver operating characteristic (ROC) curves were constructed for the two modalities. The agreement and correlation between maximum lesion diameter based on CESM and MRI, or CESM and pathology were analyzed. Results Diagnostic accuracy parameters for CESM were sensitivity 95.8 %, specificity 65.5 %, PPV 82.1 %, NPV 90.5 % and accuracy 84.4 %. The diagnostic accuracy parameters for breast MRI were sensitivity 93.8 %, specificity 82.8 %, PPV 88.2 %, NPV 92.3 %and accuracy 89.6 %. Area under the curve (AUC) of ROC was 0.96 for breast MRI and 0.88 for CESM. The Bland–Altman plots showed a mean difference of 0.7 mm with 95 % limits of agreement of 11.4 mm in tumor diameter measured using CESM and breast MRI. The differences of size measurement between CESM and breast MRI were significant, whereas no difference was observed between CESM and pathology as well as between breast MRI and pathology. The better correlation with pathological results was found in CESM than breast MRI. Conclusion Our study demonstrates that CESM possesses better diagnostic performances than breast MRI in terms of diagnostic sensitivity and lesion size assessment. And CESM is a good alternative method of screening breast cancer in high-risk people.
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Affiliation(s)
- Qingguo Wang
- Department of Radiology, Shanghai First People's Hospital, No 100, Haining Road, Hongkou District, Shanghai, China
| | - Kangan Li
- Department of Radiology, Shanghai First People's Hospital, No 100, Haining Road, Hongkou District, Shanghai, China
| | - Lihui Wang
- Department of Radiology, Shanghai First People's Hospital, No 100, Haining Road, Hongkou District, Shanghai, China
| | - Jianbing Zhang
- Department of Pathology, Shanghai First People's Hospital, Shanghai, China
| | - Zhiguo Zhou
- Department of Radiology, Shanghai First People's Hospital, No 100, Haining Road, Hongkou District, Shanghai, China
| | - Yan Feng
- Department of Radiology, Shanghai First People's Hospital, No 100, Haining Road, Hongkou District, Shanghai, China
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Diagnostic performance of contrast-enhanced spectral mammography: Systematic review and meta-analysis. Breast 2016; 28:13-9. [PMID: 27161411 DOI: 10.1016/j.breast.2016.04.008] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/31/2016] [Accepted: 04/15/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To estimate sensitivity and specificity of CESM for breast cancer diagnosis. METHODS Systematic review and meta-analysis of the accuracy of CESM in finding breast cancer in highly selected women. We estimated summary receiver operating characteristic curves, sensitivity and specificity according to quality criteria with QUADAS-2. RESULTS Six hundred four studies were retrieved, 8 of these reporting on 920 patients with 994 lesions, were eligible for inclusion. Estimated sensitivity from all studies was: 0.98 (95% CI: 0.96-1.00). Specificity was estimated from six studies reporting raw data: 0.58 (95% CI: 0.38-0.77). The majority of studies were scored as at high risk of bias due to the very selected populations. CONCLUSION CESM has a high sensitivity but very low specificity. The source studies were based on highly selected case series and prone to selection bias. High-quality studies are required to assess the accuracy of CESM in unselected cases.
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Łuczyńska E, Heinze-Paluchowska S, Hendrick E, Dyczek S, Ryś J, Herman K, Blecharz P, Jakubowicz J. Comparison between breast MRI and contrast-enhanced spectral mammography. Med Sci Monit 2015; 21:1358-67. [PMID: 25963880 PMCID: PMC4441288 DOI: 10.12659/msm.893018] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background The main goal of this study was to compare contrast-enhanced spectral mammography (CESM) and breast magnetic resonance imaging (MRI) with histopathological results and to compare the sensitivity, accuracy, and positive and negative predictive values for both imaging modalities. Material/Methods After ethics approval, CESM and MRI examinations were performed in 102 patients who had suspicious lesions described in conventional mammography. All visible lesions were evaluated independently by 2 experienced radiologists using BI-RADS classifications (scale 1–5). Dimensions of lesions measured with each modality were compared to postoperative histopathology results. Results There were 102 patients entered into CESM/MRI studies and 118 lesions were identified by the combination of CESM and breast MRI. Histopathology confirmed that 81 of 118 lesions were malignant and 37 were benign. Of the 81 malignant lesions, 72 were invasive cancers and 9 were in situ cancers. Sensitivity was 100% with CESM and 93% with breast MRI. Accuracy was 79% with CESM and 73% with breast MRI. ROC curve areas based on BI-RADS were 0.83 for CESM and 0.84 for breast MRI. Lesion size estimates on CESM and breast MRI were similar, both slightly larger than those from histopathology. Conclusions Our results indicate that CESM has the potential to be a valuable diagnostic method that enables accurate detection of malignant breast lesions, has high negative predictive value, and a false-positive rate similar to that of breast MRI.
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Affiliation(s)
- Elżbieta Łuczyńska
- Department of Radiology, Cancer Centre and Institute of Oncology, Cracow, Poland
| | | | - Edward Hendrick
- Department of Radiology, University of Colorado - Denver, School of Medicine, Aurora, CO, USA
| | - Sonia Dyczek
- Department of Radiology, Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Janusz Ryś
- Department of Pathology, Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Krzysztof Herman
- Department of Surgical Oncology, Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Paweł Blecharz
- Department of Oncological Gyneacology, Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Jerzy Jakubowicz
- Department of Radioteraphy, Cancer Centre and Institute of Oncology, Cracow, Poland
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Luczyńska E, Heinze-Paluchowska S, Dyczek S, Blecharz P, Rys J, Reinfuss M. Contrast-enhanced spectral mammography: comparison with conventional mammography and histopathology in 152 women. Korean J Radiol 2014; 15:689-96. [PMID: 25469079 PMCID: PMC4248623 DOI: 10.3348/kjr.2014.15.6.689] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 08/28/2014] [Indexed: 11/15/2022] Open
Abstract
Objective The goal of the study was to compare conventional mammography (MG) and contrast-enhanced spectral mammography (CESM) in preoperative women. Materials and Methods The study was approved by the local Ethics Committee and all participants provided informed consent. The study included 152 consecutive patients with 173 breast lesions diagnosed on MG or CESM. All MG examinations and consults were conducted in one oncology centre. Non-ionic contrast agent, at a total dose of 1.5 mL/kg body weight, was injected intravenous. Subsequently, CESM exams were performed with a mammography device, allowing dual-energy acquisitions. The entire procedure was done within the oncology centre. Images from low and high energy exposures were processed together and the combination provided an "iodine" image which outlined contrast up-take in the breast. Results MG detected 157 lesions in 150 patients, including 92 infiltrating cancers, 12 non-infiltrating cancers, and 53 benign lesions. CESM detected 149 lesions in 128 patients, including 101 infiltrating cancers, 13 non-infiltrating cancers, and 35 benign lesions. CESM sensitivity was 100% (vs. 91% for MG), specificity was 41% (vs. 15% for MG), area under the receiver operating characteristic curve was 0.86 (vs. 0.67 for MG), and accuracy was 80% (vs. 65% for MG) for the diagnosis of breast cancer. Both MG and CESM overestimated lesion sizes compared to histopathology (p < 0.001). Conclusion CESM may provide higher sensitivity for breast cancer detection and greater diagnostic accuracy than conventional mammography.
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Affiliation(s)
- Elzbieta Luczyńska
- Department of Radiology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland
| | - Sylwia Heinze-Paluchowska
- Department of Radiology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland
| | - Sonia Dyczek
- Department of Radiology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland
| | - Pawel Blecharz
- Department of Gynecologic Oncology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland
| | - Janusz Rys
- Department of Tumour Pathology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland
| | - Marian Reinfuss
- Department of Radiotherapy, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115, Poland
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