Abstract
To study the ability of contrast-enhanced digital mammography (CEDM) to accurately assess disease extent with CEDM compared to full-field digital mammography (FFDM) in patients with biopsy-proven invasive lobular carcinoma. We (ILC), we performed a single-institution retrospective review of patients with pre-operativepreoperative FFDM, CEDM, and gold reference-standard post-operativepostoperative histopathology. Both Lin's and Pearson's correlation coefficients measures were higher for CEDM (P < .05). CEDM outperformsoutperformed FFDM in assessing the extent of ILC, thereby improving surgical outcomes. Background: Invasive lobular carcinoma (ILC) is the second most frequently diagnosed breast cancer, accounting for 5% to 15% of all invasive breast cancers, yet it remains radiologically elusive in many cases. The goal of this study was to compare the ability to accurately assess disease extent with contrast-enhanced digital mammography (CEDM) and full-field digital mammography (FFDM) in patients with biopsy-proven ILC. Patients and Methods: A single-institution retrospective review of patients diagnosed with ILC with preoperative CEDM was performed. One of 3 blinded radiologist readers rereviewed cases within 1 month of another. Final size diameter was based on the largest dimension on recombined CEDM or FFDM and compared to the reference standard histopathology. Bland-Altman plots were used to visualize the differences between tumor size on imaging and pathology. Results: Thirty women were included. Mean tumor diameter was 27.0 mm (range, 7.0-118 mm) on postoperative histology, 26.0 mm on CEDM, and 16.4 mm on standard mammogram. For CEDM versus FFDM, 5 (16.7%) of 30 versus 9 (30.0%) of 30 cases underestimated pathology by > 10 mm and 5 (16.7%) of 30 versus 3 (10.0%) of 30 overestimated histopathology by > 10 mm, respectively. Two (6.7%) of 30 cases required surgical reexcision. Both Lin (0.87 vs. 0.55) and Pearson (0.87 vs. 0.70) correlation coefficient measures were higher for CEDM versus FFDM. Conclusion: CEDM outperforms standard digital mammography in ability to accurately assess disease extent in patients with biopsy-proven ILC, resulting in improved surgical outcomes. Future studies should compare surgical outcomes in patients with preoperative magnetic resonance imaging and CEDM in patients with ILC.
| Original language | English (US) |
|---|---|
| Journal | Clinical Breast Cancer |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- Breast cancer
- CEDM
- CEM
- CESM
- ILC
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Value Added of Preoperative Contrast-Enhanced Digital Mammography in Patients With Invasive Lobular Carcinoma of the Breast. / Patel, Bhavika; Davis, John; Ferraro, Christina; Kosiorek, Heidi; Hasselbach, Karl; Ocal, Tolgay; Pockaj, Barbara A.
In: Clinical Breast Cancer, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Value Added of Preoperative Contrast-Enhanced Digital Mammography in Patients With Invasive Lobular Carcinoma of the Breast
AU - Patel, Bhavika
AU - Davis, John
AU - Ferraro, Christina
AU - Kosiorek, Heidi
AU - Hasselbach, Karl
AU - Ocal, Tolgay
AU - Pockaj, Barbara A
PY - 2018/1/1
Y1 - 2018/1/1
N2 - To study the ability of contrast-enhanced digital mammography (CEDM) to accurately assess disease extent with CEDM compared to full-field digital mammography (FFDM) in patients with biopsy-proven invasive lobular carcinoma. We (ILC), we performed a single-institution retrospective review of patients with pre-operativepreoperative FFDM, CEDM, and gold reference-standard post-operativepostoperative histopathology. Both Lin's and Pearson's correlation coefficients measures were higher for CEDM (P < .05). CEDM outperformsoutperformed FFDM in assessing the extent of ILC, thereby improving surgical outcomes. Background: Invasive lobular carcinoma (ILC) is the second most frequently diagnosed breast cancer, accounting for 5% to 15% of all invasive breast cancers, yet it remains radiologically elusive in many cases. The goal of this study was to compare the ability to accurately assess disease extent with contrast-enhanced digital mammography (CEDM) and full-field digital mammography (FFDM) in patients with biopsy-proven ILC. Patients and Methods: A single-institution retrospective review of patients diagnosed with ILC with preoperative CEDM was performed. One of 3 blinded radiologist readers rereviewed cases within 1 month of another. Final size diameter was based on the largest dimension on recombined CEDM or FFDM and compared to the reference standard histopathology. Bland-Altman plots were used to visualize the differences between tumor size on imaging and pathology. Results: Thirty women were included. Mean tumor diameter was 27.0 mm (range, 7.0-118 mm) on postoperative histology, 26.0 mm on CEDM, and 16.4 mm on standard mammogram. For CEDM versus FFDM, 5 (16.7%) of 30 versus 9 (30.0%) of 30 cases underestimated pathology by > 10 mm and 5 (16.7%) of 30 versus 3 (10.0%) of 30 overestimated histopathology by > 10 mm, respectively. Two (6.7%) of 30 cases required surgical reexcision. Both Lin (0.87 vs. 0.55) and Pearson (0.87 vs. 0.70) correlation coefficient measures were higher for CEDM versus FFDM. Conclusion: CEDM outperforms standard digital mammography in ability to accurately assess disease extent in patients with biopsy-proven ILC, resulting in improved surgical outcomes. Future studies should compare surgical outcomes in patients with preoperative magnetic resonance imaging and CEDM in patients with ILC.
AB - To study the ability of contrast-enhanced digital mammography (CEDM) to accurately assess disease extent with CEDM compared to full-field digital mammography (FFDM) in patients with biopsy-proven invasive lobular carcinoma. We (ILC), we performed a single-institution retrospective review of patients with pre-operativepreoperative FFDM, CEDM, and gold reference-standard post-operativepostoperative histopathology. Both Lin's and Pearson's correlation coefficients measures were higher for CEDM (P < .05). CEDM outperformsoutperformed FFDM in assessing the extent of ILC, thereby improving surgical outcomes. Background: Invasive lobular carcinoma (ILC) is the second most frequently diagnosed breast cancer, accounting for 5% to 15% of all invasive breast cancers, yet it remains radiologically elusive in many cases. The goal of this study was to compare the ability to accurately assess disease extent with contrast-enhanced digital mammography (CEDM) and full-field digital mammography (FFDM) in patients with biopsy-proven ILC. Patients and Methods: A single-institution retrospective review of patients diagnosed with ILC with preoperative CEDM was performed. One of 3 blinded radiologist readers rereviewed cases within 1 month of another. Final size diameter was based on the largest dimension on recombined CEDM or FFDM and compared to the reference standard histopathology. Bland-Altman plots were used to visualize the differences between tumor size on imaging and pathology. Results: Thirty women were included. Mean tumor diameter was 27.0 mm (range, 7.0-118 mm) on postoperative histology, 26.0 mm on CEDM, and 16.4 mm on standard mammogram. For CEDM versus FFDM, 5 (16.7%) of 30 versus 9 (30.0%) of 30 cases underestimated pathology by > 10 mm and 5 (16.7%) of 30 versus 3 (10.0%) of 30 overestimated histopathology by > 10 mm, respectively. Two (6.7%) of 30 cases required surgical reexcision. Both Lin (0.87 vs. 0.55) and Pearson (0.87 vs. 0.70) correlation coefficient measures were higher for CEDM versus FFDM. Conclusion: CEDM outperforms standard digital mammography in ability to accurately assess disease extent in patients with biopsy-proven ILC, resulting in improved surgical outcomes. Future studies should compare surgical outcomes in patients with preoperative magnetic resonance imaging and CEDM in patients with ILC.
KW - Breast cancer
KW - CEDM
KW - CEM
KW - CESM
KW - ILC
UR - http://www.scopus.com/inward/record.url?scp=85051521441&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85051521441&partnerID=8YFLogxK
U2 - 10.1016/j.clbc.2018.07.012
DO - 10.1016/j.clbc.2018.07.012
M3 - Article
C2 - 30122347
AN - SCOPUS:85051521441
JO - Clinical Breast Cancer
JF - Clinical Breast Cancer
SN - 1526-8209
ER -