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Título

EXPERIENCE WITH CONTRAST-ENHANCED MAMMOGRAPHY: BREAST CANCER DETECTION IN PATIENTS REFERRED TO PERCUTANEOUS BIOPSIES

Título em Inglês

EXPERIENCE WITH CONTRAST-ENHANCED MAMMOGRAPHY: BREAST CANCER DETECTION IN PATIENTS REFERRED TO PERCUTANEOUS BIOPSIES

Introdução

Introduction: Breast cancer is the leading cause of cancer death in the Brazilian female population, and it is the most common malignant tumor in women in the world. The only method that has proven to decrease breast cancer mortality is mammography and, therefore, screening programs are based on this test in several countries. However, its sensitivity in the general population ranges from 75% to 80%, being especially lower in the case of dense breasts, more common in young women, ranging from 30% to 48% in this group (1). The most sensitive method in the detection of breast cancer is magnetic resonance imaging, (80% to 97.8%, according to current studies) (2), due to its ability of studing vascular changings in the tissues. Aiming to combine the morphological study provided by mammography with the analysis of tumor perfusion allowed by studies that use intravenous contrasts, contrast enhanced digital mammography (CEDM) or angiomammography was developed (3).

Objetivos

Objective: Assess whether CEDM is an effective method in the detection of breast cancer, as well as its reliability to rule out the presence of malignancy.

Métodos

Methods: Patients were recruited at the time of attendance to the service for breast percutaneous biopsy of lesions detected on previous mamography and /or ultrassound examinations, previously requested by their physicians. Those who made themselves available to participate in this study did sign the Free and Informed Consent Form (FICF). Patients werw submited to bilateral mammographic study in craniocaudal and mediolateral oblique incidences, obtaining low-energy images and recombined high-energy images. Low-energy images, equivalent to digital mammography, were described and classified according to the BI-RADS lexicon. The contrasted studies were described in order to comply with the recommendations of the current literature, observing that, until nowadays, there is no standardization by BI-RADS for contrast mammography reports. These studies were compared to histopathological findings of biopsies, the gold standard in this study.

Resultados

Results: This is an ongoing investigation. From September / 2019 to October / 2020, 180 patients underwent CEDM and percutaneous biopsies. 27 invasive carcinomas (CDI) and 10 ductal carcinomas in situ (CDIS). 26 of the 27 CDI cases and all of the CDIS cases had positive CEDM findings. Among CDIS cases, 6 had no abnormal enhancemente on CEDM, but were evident on 2D study. The observed sensitivity was of 97%.

Conclusões

Conclusions: This preliminary results demonstrated that CEDM is a high sensitive method for breast cancer detection, including non invasive lesions. The study is still in progress and further data is needed to describe the benefits of CEDM on breast cancer detection.

Palavras Chave

Área

DETECTION / DIAGNOSIS - Imaging and Screening