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Accuracy and Reproducibility of Contrast-Enhanced Mammography in the Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Patients with Calcifications in the Tumor Bed

This study aimed to evaluate contrast-enhanced mammography (CEM) accuracy and reproducibility in the detection and measurement of residual tumor after neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients with calcifications, using surgical specimen pathology as the reference. Pre- and post-...

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Autores principales: Iotti, Valentina, Ragazzi, Moira, Besutti, Giulia, Marchesi, Vanessa, Ravaioli, Sara, Falco, Giuseppe, Coiro, Saverio, Bisagni, Alessandra, Gasparini, Elisa, Giorgi Rossi, Paolo, Vacondio, Rita, Pattacini, Pierpaolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999407/
https://www.ncbi.nlm.nih.gov/pubmed/33806306
http://dx.doi.org/10.3390/diagnostics11030435
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author Iotti, Valentina
Ragazzi, Moira
Besutti, Giulia
Marchesi, Vanessa
Ravaioli, Sara
Falco, Giuseppe
Coiro, Saverio
Bisagni, Alessandra
Gasparini, Elisa
Giorgi Rossi, Paolo
Vacondio, Rita
Pattacini, Pierpaolo
author_facet Iotti, Valentina
Ragazzi, Moira
Besutti, Giulia
Marchesi, Vanessa
Ravaioli, Sara
Falco, Giuseppe
Coiro, Saverio
Bisagni, Alessandra
Gasparini, Elisa
Giorgi Rossi, Paolo
Vacondio, Rita
Pattacini, Pierpaolo
author_sort Iotti, Valentina
collection PubMed
description This study aimed to evaluate contrast-enhanced mammography (CEM) accuracy and reproducibility in the detection and measurement of residual tumor after neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients with calcifications, using surgical specimen pathology as the reference. Pre- and post-NAC CEM images of 36 consecutive BC patients receiving NAC in 2012–2020, with calcifications in the tumor bed at diagnosis, were retrospectively reviewed by two radiologists; described were absence/presence and size of residual disease based on contrast enhancement (CE) only and CE plus calcifications. Twenty-eight patients (77.8%) had invasive and 5 (13.9%) in situ-only residual disease at surgical specimen pathology. Considering CE plus calcifications instead of CE only, CEM sensitivity for invasive residual tumor increased from 85.7% (95% CI = 67.3–96%) to 96.4% (95% CI = 81.7–99.9%) and specificity decreased from 5/8 (62.5%; 95% CI = 24.5–91.5%) to 1/8 (14.3%; 95% CI = 0.4–57.9%). For in situ-only residual disease, false negatives decreased from 3 to 0 and false positives increased from 1 to 2. CEM pathology concordance in residual disease measurement increased (R squared from 0.38 to 0.45); inter-reader concordance decreased (R squared from 0.79 to 0.66). Considering CE plus calcifications to evaluate NAC response in BC patients increases sensitivity in detection and accuracy in measurement of residual disease but increases false positives.
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spelling pubmed-79994072021-03-28 Accuracy and Reproducibility of Contrast-Enhanced Mammography in the Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Patients with Calcifications in the Tumor Bed Iotti, Valentina Ragazzi, Moira Besutti, Giulia Marchesi, Vanessa Ravaioli, Sara Falco, Giuseppe Coiro, Saverio Bisagni, Alessandra Gasparini, Elisa Giorgi Rossi, Paolo Vacondio, Rita Pattacini, Pierpaolo Diagnostics (Basel) Article This study aimed to evaluate contrast-enhanced mammography (CEM) accuracy and reproducibility in the detection and measurement of residual tumor after neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients with calcifications, using surgical specimen pathology as the reference. Pre- and post-NAC CEM images of 36 consecutive BC patients receiving NAC in 2012–2020, with calcifications in the tumor bed at diagnosis, were retrospectively reviewed by two radiologists; described were absence/presence and size of residual disease based on contrast enhancement (CE) only and CE plus calcifications. Twenty-eight patients (77.8%) had invasive and 5 (13.9%) in situ-only residual disease at surgical specimen pathology. Considering CE plus calcifications instead of CE only, CEM sensitivity for invasive residual tumor increased from 85.7% (95% CI = 67.3–96%) to 96.4% (95% CI = 81.7–99.9%) and specificity decreased from 5/8 (62.5%; 95% CI = 24.5–91.5%) to 1/8 (14.3%; 95% CI = 0.4–57.9%). For in situ-only residual disease, false negatives decreased from 3 to 0 and false positives increased from 1 to 2. CEM pathology concordance in residual disease measurement increased (R squared from 0.38 to 0.45); inter-reader concordance decreased (R squared from 0.79 to 0.66). Considering CE plus calcifications to evaluate NAC response in BC patients increases sensitivity in detection and accuracy in measurement of residual disease but increases false positives. MDPI 2021-03-04 /pmc/articles/PMC7999407/ /pubmed/33806306 http://dx.doi.org/10.3390/diagnostics11030435 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Iotti, Valentina
Ragazzi, Moira
Besutti, Giulia
Marchesi, Vanessa
Ravaioli, Sara
Falco, Giuseppe
Coiro, Saverio
Bisagni, Alessandra
Gasparini, Elisa
Giorgi Rossi, Paolo
Vacondio, Rita
Pattacini, Pierpaolo
Accuracy and Reproducibility of Contrast-Enhanced Mammography in the Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Patients with Calcifications in the Tumor Bed
title Accuracy and Reproducibility of Contrast-Enhanced Mammography in the Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Patients with Calcifications in the Tumor Bed
title_full Accuracy and Reproducibility of Contrast-Enhanced Mammography in the Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Patients with Calcifications in the Tumor Bed
title_fullStr Accuracy and Reproducibility of Contrast-Enhanced Mammography in the Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Patients with Calcifications in the Tumor Bed
title_full_unstemmed Accuracy and Reproducibility of Contrast-Enhanced Mammography in the Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Patients with Calcifications in the Tumor Bed
title_short Accuracy and Reproducibility of Contrast-Enhanced Mammography in the Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Patients with Calcifications in the Tumor Bed
title_sort accuracy and reproducibility of contrast-enhanced mammography in the assessment of response to neoadjuvant chemotherapy in breast cancer patients with calcifications in the tumor bed
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999407/
https://www.ncbi.nlm.nih.gov/pubmed/33806306
http://dx.doi.org/10.3390/diagnostics11030435
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