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Contrast-Enhanced Mammography (CEM) compared to Breast Magnetic Resonance (MRI) in the evaluation of breast lobular neoplasia

  • Epidemiology
  • Published:
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Abstract

Purpose

To compare the diagnostic performance (detection, assessment of correct disease extent and multifocality/centricity) of Contrast-Enhanced Mammography (CEM) Versus Breast Magnetic Resonance (MRI) in the study of lobular neoplasms.

Methods

We retrospectively selected all the patients who underwent surgery for a lobular breast neoplasm, either an in situ or an invasive tumor, and had undergone both breast CEM and MRI examinations during the pre-surgical planning. Wilcoxon Signed Rank test was performed to assess the differences between size measurements using the different methods and the post-surgical pathological measurements, considered the gold standard. The agreement in identifying multifocality/multicentricity among the different methods and the pathology was assessed using the Kappa statistics.

Results

We selected 19 patients, of which one presented a bilateral neoplasm. Then, the images of these 19 patients were analyzed, for a total of 52 malignant breast lesions. We found no significant differences between the post-surgical pathological size of the lesions and the calculated size with CEM and MRI (p-value of the difference respectively 0.71 and 0.47). In all 20 cases, neoplasm detection was possible both with CEM and MRI. CEM and MRI showed an excellent ability to identify multifocal and multicentric cases (K statistic equal to 0.93 for both the procedures), while K statistic was 0.11 and 0.59 for FFDM and US, respectively.

Conclusion

The findings of this study suggest that CEM is a reliable imaging technique in the preoperative setting of patients with lobular neoplasm, with comparable results to breast MRI.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This work was partially supported by the Italian Ministry of Health Ricerca Corrente 5x1000 funds.

Funding

This study did not receive funding.

Author information

Authors and Affiliations

  1. Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141, Milan, Italy

    Luca Nicosia, Anna Rotili, Filippo Pesapane, Anna Carla Bozzini & Enrico Cassano

  2. Postgraduation School of Diagnostic and Interventional Radiology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy

    Ottavia Battaglia & Giuseppe Pellegrino

  3. Department of Oncology and Hemato-Oncology, University of Milan, 20122, Milan, Italy

    Nicola Fusco & Giovanni Corso

  4. Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy

    Nicola Fusco & Francesca Maria Porta

  5. School of Pathology, University of Milan, 20122, Milan, Italy

    Francesca Maria Porta

  6. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126, Milan, Italy

    Samuele Frassoni & Vincenzo Bagnardi

  7. Division of Breast Surgery, European Institute of Oncology (IEO), IRCCS, Via Ripamonti, 435, 20141, Milan, Italy

    Giovanni Corso

  8. European Cancer Prevention Organization (ECP), 20122, Milan, Italy

    Giovanni Corso & Claudia Sangalli

  9. Data Management, IEO European Institute of Oncology IRCCS, 20141, Milan, Italy

    Claudia Sangalli

Authors
  1. Luca Nicosia
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Contributions

Conceptualization: LN, OB; AR; methodology: FP and ACB; validation: ACB and GP; resources: NF; EC; writing—original draft preparation: LN and OB; writing—review and editing: all authors. Statystical analysis: SF; VB; data managment: CS; supervision, GC and EC. All authors read and approved the Final manuscript.

Corresponding author

Correspondence to Luca Nicosia.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of the local Institution (European Institute of Oncology, 20141, Milano).

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All patients have signed a written informed consent (Protocol number IEO 960).

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Nicosia, L., Rotili, A., Pesapane, F. et al. Contrast-Enhanced Mammography (CEM) compared to Breast Magnetic Resonance (MRI) in the evaluation of breast lobular neoplasia. Breast Cancer Res Treat 203, 135–143 (2024). https://doi.org/10.1007/s10549-023-07096-7

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