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The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer

Contrast-enhanced spectral mammography (CESM) is a promising, digital breast imaging method for planning surgeries. The study aimed at comparing digital mammography (MG) with CESM as predictive factors in visualizing multifocal-multicentric cancers (MFMCC) before determining the surgery extent. We a...

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Autores principales: Lorek, Andrzej, Steinhof-Radwańska, Katarzyna, Barczyk-Gutkowska, Anna, Zarębski, Wojciech, Paleń, Piotr, Szyluk, Karol, Lorek, Joanna, Grażyńska, Anna, Niemiec, Paweł, Gisterek, Iwona
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293137/
https://www.ncbi.nlm.nih.gov/pubmed/34287253
http://dx.doi.org/10.3390/curroncol28040232
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author Lorek, Andrzej
Steinhof-Radwańska, Katarzyna
Barczyk-Gutkowska, Anna
Zarębski, Wojciech
Paleń, Piotr
Szyluk, Karol
Lorek, Joanna
Grażyńska, Anna
Niemiec, Paweł
Gisterek, Iwona
author_facet Lorek, Andrzej
Steinhof-Radwańska, Katarzyna
Barczyk-Gutkowska, Anna
Zarębski, Wojciech
Paleń, Piotr
Szyluk, Karol
Lorek, Joanna
Grażyńska, Anna
Niemiec, Paweł
Gisterek, Iwona
author_sort Lorek, Andrzej
collection PubMed
description Contrast-enhanced spectral mammography (CESM) is a promising, digital breast imaging method for planning surgeries. The study aimed at comparing digital mammography (MG) with CESM as predictive factors in visualizing multifocal-multicentric cancers (MFMCC) before determining the surgery extent. We analyzed 999 patients after breast cancer surgery to compare MG and CESM in terms of detecting MFMCC. Moreover, these procedures were assessed for their conformity with postoperative histopathology (HP), calculating their sensitivity and specificity. The question was which histopathological types of breast cancer were more frequently characterized by multifocality–multicentrality in comparable techniques as regards the general number of HP-identified cancers. The analysis involved the frequency of post-CESM changes in the extent of planned surgeries. In the present study, MG revealed 48 (4.80%) while CESM 170 (17.02%) MFMCC lesions, subsequently confirmed in HP. MG had MFMCC detecting sensitivity of 38.51%, specificity 99.01%, PPV (positive predictive value) 85.71%, and NPV (negative predictive value) 84.52%. The respective values for CESM were 87.63%, 94.90%, 80.57% and 96.95%. Moreover, no statistically significant differences were found between lobular and NST cancers (27.78% vs. 21.24%) regarding MFMCC. A treatment change was required by 20.00% of the patients from breast-conserving to mastectomy, upon visualizing MFMCC in CESM. In conclusion, mammography offers insufficient diagnostic sensitivity for detecting additional cancer foci. The high diagnostic sensitivity of CESM effectively assesses breast cancer multifocality/multicentrality and significantly changes the extent of planned surgeries. The multifocality/multicentrality concerned carcinoma, lobular and invasive carcinoma of no special type (NST) cancers with similar incidence rates, which requires further confirmation.
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spelling pubmed-82931372021-07-22 The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer Lorek, Andrzej Steinhof-Radwańska, Katarzyna Barczyk-Gutkowska, Anna Zarębski, Wojciech Paleń, Piotr Szyluk, Karol Lorek, Joanna Grażyńska, Anna Niemiec, Paweł Gisterek, Iwona Curr Oncol Article Contrast-enhanced spectral mammography (CESM) is a promising, digital breast imaging method for planning surgeries. The study aimed at comparing digital mammography (MG) with CESM as predictive factors in visualizing multifocal-multicentric cancers (MFMCC) before determining the surgery extent. We analyzed 999 patients after breast cancer surgery to compare MG and CESM in terms of detecting MFMCC. Moreover, these procedures were assessed for their conformity with postoperative histopathology (HP), calculating their sensitivity and specificity. The question was which histopathological types of breast cancer were more frequently characterized by multifocality–multicentrality in comparable techniques as regards the general number of HP-identified cancers. The analysis involved the frequency of post-CESM changes in the extent of planned surgeries. In the present study, MG revealed 48 (4.80%) while CESM 170 (17.02%) MFMCC lesions, subsequently confirmed in HP. MG had MFMCC detecting sensitivity of 38.51%, specificity 99.01%, PPV (positive predictive value) 85.71%, and NPV (negative predictive value) 84.52%. The respective values for CESM were 87.63%, 94.90%, 80.57% and 96.95%. Moreover, no statistically significant differences were found between lobular and NST cancers (27.78% vs. 21.24%) regarding MFMCC. A treatment change was required by 20.00% of the patients from breast-conserving to mastectomy, upon visualizing MFMCC in CESM. In conclusion, mammography offers insufficient diagnostic sensitivity for detecting additional cancer foci. The high diagnostic sensitivity of CESM effectively assesses breast cancer multifocality/multicentrality and significantly changes the extent of planned surgeries. The multifocality/multicentrality concerned carcinoma, lobular and invasive carcinoma of no special type (NST) cancers with similar incidence rates, which requires further confirmation. MDPI 2021-07-12 /pmc/articles/PMC8293137/ /pubmed/34287253 http://dx.doi.org/10.3390/curroncol28040232 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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lorek, Andrzej
Steinhof-Radwańska, Katarzyna
Barczyk-Gutkowska, Anna
Zarębski, Wojciech
Paleń, Piotr
Szyluk, Karol
Lorek, Joanna
Grażyńska, Anna
Niemiec, Paweł
Gisterek, Iwona
The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer
title The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer
title_full The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer
title_fullStr The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer
title_full_unstemmed The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer
title_short The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer
title_sort usefulness of spectral mammography in surgical planning of breast cancer treatment—analysis of 999 patients with primary operable breast cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293137/
https://www.ncbi.nlm.nih.gov/pubmed/34287253
http://dx.doi.org/10.3390/curroncol28040232
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