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Head-to-head comparison of contrast-enhanced mammography and contrast-enhanced MRI for assessing pathological complete response to neoadjuvant therapy in patients with breast cancer: a meta-analysis

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Abstract

Objective

Breast cancer patients receiving neoadjuvant therapy (NAT) are in need of a more patient-friendly imaging modality such as contrast-enhanced mammography (CEM) for monitoring therapy response. The purpose of this study was to conduct a meta-analysis to compare the diagnostic performances of CEM and contrast-enhanced magnetic resonance imaging (CE-MRI) for assessing pathological complete response (pCR) in these patients.

Methods

The PubMed, Embase, and Cochrane Library databases were searched through March 2023 to identify studies reporting a head-to-head comparison of CEM and CE-MRI in detecting pCR in breast cancer patients receiving NAT. Pooled diagnostic performance was calculated using a bivariate random-effects model, and an AUC was derived for each test from hierarchic summary ROC analysis.

Results

Six studies with 328 patients were included. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were 93% (95% CI 84–97%), 68% (95% CI 60–76%), and 29.29 (95% CI 11.41–75.18) for CEM versus 84% (95% CI 62–95%), 80% (95% CI 71–87%), and 21.39 (95% CI 5.94–77.13) for CE-MRI. The AUC was 0.85 (95% CI 0.82–0.88) for CEM and 0.85 (95% CI 0.82–0.88) for CE-MRI.

Conclusion

This meta-analysis of head-to-head comparison studies showed that CEM provides an equivalent diagnostic accuracy to CE-MRI in identification of pCR in breast cancer patients receiving NAT. The results support the increasing use of CEM in this setting and would encourage future studies to validate CEM as a suitable replacement for MRI.

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Data availability

Enquiries about data availability should be directed to the authors.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Author notes

  1. Min Kaiyin and Tong Lingling have equally contributed to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, 130033, China

    Min Kaiyin & Ji Bin

  2. Department of Gynecology, China-Japan Union Hospital of Jilin University, Changchun, China

    Tong Lingling

  3. Department of Imaging, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China

    Tang Leilei

  4. Department of Breast Surgery, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, 130033, China

    Li Wenjia

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  1. Min Kaiyin
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Kaiyin, M., Lingling, T., Leilei, T. et al. Head-to-head comparison of contrast-enhanced mammography and contrast-enhanced MRI for assessing pathological complete response to neoadjuvant therapy in patients with breast cancer: a meta-analysis. Breast Cancer Res Treat 202, 1–9 (2023). https://doi.org/10.1007/s10549-023-07034-7

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