Comparison of Contrast-Enhanced Spectral Mammography and Contrast-Enhanced MRI in Screening Multifocal and Multicentric Lesions in Breast Cancer Patients

OBJECTIVES: We aimed to determine the difference between contrast-enhanced spectral mammography (CESM) and contrast-enhanced magnetic resonance imaging (CE-MRI) in detecting multifocal and multicentric breast cancer (MMBC). METHODS: : This study was conducted among breast cancer patients between July 1, 2017, and May 30, 2021. The sensitivity, specificity, and accuracy of CESM and CE-MRI in the diagnosis of MMBC were evaluated with pathological results as the gold standard. RESULTS: A total of 188 lesions were detected in 54 patients with MMBC, including 177 breast cancer and 11 benign lesions. Based on CESM and CE-MRI, 4 false-positive cases and 3 false-negative cases and 7 false-positive cases and 1 false-negative case, respectively, were found. The accuracy of CESM was higher than that of MRI (96.3% vs 95.7%), and the specificity was higher than that of MRI (63.6% vs 36.4%). There were no significant differences in the sensitivity, specificity, and accuracy for the detection of MMBC between CESM and CE-MRI (p = 0.500; p = 0.250; p = 0.792). CONCLUSION: CESM is an effective method for the detection of MMBC, which is consistent with the sensitivity and accuracy of CE-MRI.