Purpose

Breast cancer diagnosis often involves assessing the locoregional spread of the disease through MRI, as multicentricity, multifocality and/or bilaterality are increasingly common. Contrast-enhanced mammography (CEM) is emerging as a potential alternative method. This study compares the performance of CEM and MRI in preoperative staging of women with confirmed breast carcinoma. Patients were also asked to fill in a satisfaction questionnaire to rate their comfort level with each investigation.

Methods

From May 1st, 2021 to May 1st, 2022, we enrolled 70 women with confirmed breast carcinoma who were candidates for surgery. For pre-operative locoregional staging, all patients underwent CEM and MRI examination, which two radiologists evaluated blindly. We further investigated all suspicious locations for disease spread, identified by both CEM and MRI, with a second-look ultrasound (US) and eventual histological examination.

Results

In our study cohort, MRI and CEM identified 114 and 102 areas of focal contrast enhancement, respectively. A true discrepancy between MRI and CEM occurred in 9 out of 70 patients examined. MRI reported 8 additional lesions that proved to be false positives on second-look US in 6 patients, while it identified 4 lesions that were not detected by CEM and were pathological (true positives) in 3 patients.

Conclusions

CEM showed results comparable to MRI in the staging of breast cancer in our study population, with a high rate of patient acceptability.

中文翻译：

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乳腺癌的局部分期：对比增强乳房X光检查与乳房磁共振成像

目的

乳腺癌诊断通常涉及通过 MRI 评估疾病的局部扩散，因为多中心、多灶性和/或双侧性越来越常见。对比增强乳房X线摄影（CEM）正在成为一种潜在的替代方法。本研究比较了 CEM 和 MRI 在确诊乳腺癌女性术前分期中的表现。患者还被要求填写满意度调查问卷，以评估他们对每项调查的舒适程度。

方法

从2021年5月1日到2022年5月1日，我们招募了70名确诊乳腺癌且适合接受手术的女性。对于术前局部分期，所有患者均接受了 CEM 和 MRI 检查，由两名放射科医生进行盲法评估。我们进一步调查了所有可疑的疾病传播部位，通过 CEM 和 MRI 识别，并进行二次超声检查 (US) 和最终的组织学检查。

结果

在我们的研究队列中，MRI 和 CEM 分别识别出 114 个和 102 个局部对比度增强区域。在接受检查的 70 名患者中，有 9 名患者出现了 MRI 和 CEM 之间的真正差异。 MRI 报告了另外 8 个病灶，在 6 名患者的二次超声检查中被证明为假阳性，同时在 3 名患者中发现了 4 个 CEM 未检测到的病理病灶（真阳性）。

结论

在我们的研究人群中，CEM 在乳腺癌分期方面显示出与 MRI 相当的结果，并且患者接受率很高。