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Impact of background parenchymal enhancement levels on the diagnosis of contrast-enhanced digital mammography in evaluations of breast cancer: comparison with contrast-enhanced breast MRI

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Abstract

Purpose

To compare the diagnostic performances of contrast-enhanced digital mammography (CEDM) and breast MRI in evaluations of breast cancer, with a focus on the impact of background parenchymal enhancement (BPE) levels.

Methods

The present study included women who underwent CEDM and breast MRI to evaluate the disease extent of breast cancer between January 2018 and December 2019. Readers judged BPE levels (minimal-mild or moderate-marked) on CEDM, and were asked to assign findings suggesting malignancy using the following criteria: (1) enhancement other than BPE and (2) BI-RADS 4/5 calcifications without enhancement. On MRI, BI-RADS 3 and BI-RADS 4/5 lesions were evaluated as benign and malignant, respectively. The diagnostic performances of CEDM and MRI were compared separately between women with minimal-mild BPE and those with moderate-marked BPE.

Results

Sixty-nine patients comprising 43 postmenopausal and 26 premenopausal women were included in the present study. In total, 195 lesions (94 malignant and 101 benign) were identified. The sensitivity and specificity of CEDM for the diagnosis of all lesions were 90.8 and 91.5% with minimal-mild BPE and 79.3 and 76.2% with moderate-marked BPE, respectively. The sensitivity and specificity of MRI were 90.0% and 71.0% with minimal-mild BPE and 87.5% and 78.1% with moderate-marked BPE, respectively. The accuracy of CEDM was significantly superior to that of MRI in women with minimal-mild BPE on both CEDM and MRI (p = 0.002). Regarding the negative impact of a correct diagnosis on CEDM, the odds ratio of “moderate-marked BPE” was 0.382.

Conclusion

In patients with minimal-mild BPE, the diagnostic performance of CEDM was superior to that of MRI.

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Acknowledgements

This study was supported by a research grant from FUJIFILM Corporation (Tokyo, Japan). The statistical analysis was conducted by Cimic Co., Ltd. We greatly appreciate all medical staff and clinical research coordinators in this clinical study for their contributions.

Funding

This study was supported by a research grant from FUJIFILM Corporation.

Author information

Authors and Affiliations

  1. Department of Breast Surgery and Oncology, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe, 651-0072, Japan

    Sachiko Yuen, Ayako Gose, Seiji Yanai, Yoshihiro Yata, Hajime Matsumoto, You Ichinose & Kazuhiko Yamagami

  2. Breast Research Center, The Shinko Institution for Medical Research, Shinko Hospital, Kobe, Japan

    Sachiko Yuen, Ayako Gose, Seiji Yanai, Yoshihiro Yata, Hajime Matsumoto & Kazuhiko Yamagami

  3. Department of Diagnostic Radiology, Shinko Hospital, Kobe, Japan

    Shuichi Monzawa

  4. Department of Pathology, Shinko Hospital, Kobe, Japan

    Takashi Tashiro

Authors
  1. Sachiko Yuen
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  2. Shuichi Monzawa
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  3. Ayako Gose
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  4. Seiji Yanai
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  7. You Ichinose
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  8. Takashi Tashiro
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  9. Kazuhiko Yamagami
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Corresponding author

Correspondence to Sachiko Yuen.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This retrospective study was approved by the Certified Review Board of the Japan Registry of Clinical Trials (jRCTs052180121) and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standard.

Informed consent

Written informed consent to participate in the present study after a full explanation by the clinical research coordinator was obtained from all patients.

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Yuen, S., Monzawa, S., Gose, A. et al. Impact of background parenchymal enhancement levels on the diagnosis of contrast-enhanced digital mammography in evaluations of breast cancer: comparison with contrast-enhanced breast MRI. Breast Cancer 29, 677–687 (2022). https://doi.org/10.1007/s12282-022-01345-1

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  • DOI: https://doi.org/10.1007/s12282-022-01345-1

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