Added Value of Contrast Enhanced Spectral Mammography in Symptomatic Patients with Dense Breasts

Abstract

ontrast enhanced spectral mammography (CESM) is an emerging technique in the field of breast imaging with one of its main indications is accurate evaluation and characterization of different lesions in dense breasts where the glandular tissue could obscure underlying masses if imaged solely by full field digital mammography (FFDM). Other clinical implications of CESM include assessment of equivocal lesions detected by FFDM or ultrasound, accurate estimation of disease extent and monitoring the response to neoadjuvant chemotherapy. The aim of our study was to evaluate the supplementary value of contrast enhanced spectral mammography in assessment of symptomatic patients with dense breast. From July 2018 to July 2019, 25 symptomatic females with dense breasts (ACR C or D on FFDM) with age ranging from 21 to 66 years were chosen from breast surgery clinic at El Demerdash hospital. Patients underwent FFDM, CESM, Ultrasound and tissue core biopsy. Our study focused on assessing the capability of CESM to efficiently detect and accurately characterize clinically palpable masses as well as assessing concomitant lesions and consequently tailoring the most appropriate treatment plan suitable for each patient. The lesions were evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon designed by the American College of Radiology (ACR), site of the lesions, margin, definition and ± calcifications. In the recombined images MLO and CC views were mainly assessed for the presence or absence of enhancement as well as the type of enhancement (mass or non-mass) and its degree and homogeneity.