Contrast-Enhanced Spectral Mammography in the Evaluation of Breast Microcalcifications: Controversies and Diagnostic Management
The aim of this study was to evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) in predicting breast lesion malignancy due to microcalcifications compared to lesions that present with other radiological findings. Three hundred and twenty-one patients with 377 breast...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-02-01
|
| Series: | Healthcare |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9032/11/4/511 |
| _version_ | 1797620752115040256 |
|---|---|
| author | Luca Nicosia Anna Carla Bozzini Giulia Signorelli Simone Palma Filippo Pesapane Samuele Frassoni Vincenzo Bagnardi Maria Pizzamiglio Mariagiorgia Farina Chiara Trentin Silvia Penco Lorenza Meneghetti Claudia Sangalli Enrico Cassano |
| author_facet | Luca Nicosia Anna Carla Bozzini Giulia Signorelli Simone Palma Filippo Pesapane Samuele Frassoni Vincenzo Bagnardi Maria Pizzamiglio Mariagiorgia Farina Chiara Trentin Silvia Penco Lorenza Meneghetti Claudia Sangalli Enrico Cassano |
| author_sort | Luca Nicosia |
| collection | DOAJ |
| description | The aim of this study was to evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) in predicting breast lesion malignancy due to microcalcifications compared to lesions that present with other radiological findings. Three hundred and twenty-one patients with 377 breast lesions that underwent CESM and histological assessment were included. All the lesions were scored using a 4-point qualitative scale according to the degree of contrast enhancement at the CESM examination. The histological results were considered the gold standard. In the first analysis, enhancement degree scores of 2 and 3 were considered predictive of malignity. The sensitivity (SE) and positive predictive value (PPV) were significative lower for patients with lesions with microcalcifications without other radiological findings (SE = 53.3% vs. 82.2%, <i>p</i>-value < 0.001 and PPV = 84.2% vs. 95.2%, <i>p</i>-value = 0.049, respectively). On the contrary, the specificity (SP) and negative predictive value (NPV) were significative higher among lesions with microcalcifications without other radiological findings (SP = 95.8% vs. 84.2%, <i>p</i>-value = 0.026 and NPV = 82.9% vs. 55.2%, <i>p</i>-value < 0.001, respectively). In a second analysis, degree scores of 1, 2, and 3 were considered predictive of malignity. The SE (80.0% vs. 96.8%, <i>p</i>-value < 0.001) and PPV (70.6% vs. 88.3%, <i>p</i>-value: 0.005) were significantly lower among lesions with microcalcifications without other radiological findings, while the SP (85.9% vs. 50.9%, <i>p</i>-value < 0.001) was higher. The enhancement of microcalcifications has low sensitivity in predicting malignancy. However, in certain controversial cases, the absence of CESM enhancement due to its high negative predictive value can help to reduce the number of biopsies for benign lesions |
| first_indexed | 2024-03-11T08:46:06Z |
| format | Article |
| id | doaj.art-a30b64586dc840dfb449bc9594e7c780 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-11T08:46:06Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-a30b64586dc840dfb449bc9594e7c7802023-11-16T20:46:16ZengMDPI AGHealthcare2227-90322023-02-0111451110.3390/healthcare11040511Contrast-Enhanced Spectral Mammography in the Evaluation of Breast Microcalcifications: Controversies and Diagnostic ManagementLuca Nicosia0Anna Carla Bozzini1Giulia Signorelli2Simone Palma3Filippo Pesapane4Samuele Frassoni5Vincenzo Bagnardi6Maria Pizzamiglio7Mariagiorgia Farina8Chiara Trentin9Silvia Penco10Lorenza Meneghetti11Claudia Sangalli12Enrico Cassano13Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyDepartment of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, ItalyBreast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyDepartment of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126 Milan, ItalyDepartment of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126 Milan, ItalyBreast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyData Management, European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyThe aim of this study was to evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) in predicting breast lesion malignancy due to microcalcifications compared to lesions that present with other radiological findings. Three hundred and twenty-one patients with 377 breast lesions that underwent CESM and histological assessment were included. All the lesions were scored using a 4-point qualitative scale according to the degree of contrast enhancement at the CESM examination. The histological results were considered the gold standard. In the first analysis, enhancement degree scores of 2 and 3 were considered predictive of malignity. The sensitivity (SE) and positive predictive value (PPV) were significative lower for patients with lesions with microcalcifications without other radiological findings (SE = 53.3% vs. 82.2%, <i>p</i>-value < 0.001 and PPV = 84.2% vs. 95.2%, <i>p</i>-value = 0.049, respectively). On the contrary, the specificity (SP) and negative predictive value (NPV) were significative higher among lesions with microcalcifications without other radiological findings (SP = 95.8% vs. 84.2%, <i>p</i>-value = 0.026 and NPV = 82.9% vs. 55.2%, <i>p</i>-value < 0.001, respectively). In a second analysis, degree scores of 1, 2, and 3 were considered predictive of malignity. The SE (80.0% vs. 96.8%, <i>p</i>-value < 0.001) and PPV (70.6% vs. 88.3%, <i>p</i>-value: 0.005) were significantly lower among lesions with microcalcifications without other radiological findings, while the SP (85.9% vs. 50.9%, <i>p</i>-value < 0.001) was higher. The enhancement of microcalcifications has low sensitivity in predicting malignancy. However, in certain controversial cases, the absence of CESM enhancement due to its high negative predictive value can help to reduce the number of biopsies for benign lesionshttps://www.mdpi.com/2227-9032/11/4/511CESMbreast cancermicrocalcificationsbreast biopsy |
| spellingShingle | Luca Nicosia Anna Carla Bozzini Giulia Signorelli Simone Palma Filippo Pesapane Samuele Frassoni Vincenzo Bagnardi Maria Pizzamiglio Mariagiorgia Farina Chiara Trentin Silvia Penco Lorenza Meneghetti Claudia Sangalli Enrico Cassano Contrast-Enhanced Spectral Mammography in the Evaluation of Breast Microcalcifications: Controversies and Diagnostic Management Healthcare CESM breast cancer microcalcifications breast biopsy |
| title | Contrast-Enhanced Spectral Mammography in the Evaluation of Breast Microcalcifications: Controversies and Diagnostic Management |
| title_full | Contrast-Enhanced Spectral Mammography in the Evaluation of Breast Microcalcifications: Controversies and Diagnostic Management |
| title_fullStr | Contrast-Enhanced Spectral Mammography in the Evaluation of Breast Microcalcifications: Controversies and Diagnostic Management |
| title_full_unstemmed | Contrast-Enhanced Spectral Mammography in the Evaluation of Breast Microcalcifications: Controversies and Diagnostic Management |
| title_short | Contrast-Enhanced Spectral Mammography in the Evaluation of Breast Microcalcifications: Controversies and Diagnostic Management |
| title_sort | contrast enhanced spectral mammography in the evaluation of breast microcalcifications controversies and diagnostic management |
| topic | CESM breast cancer microcalcifications breast biopsy |
| url | https://www.mdpi.com/2227-9032/11/4/511 |
| work_keys_str_mv | AT lucanicosia contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT annacarlabozzini contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT giuliasignorelli contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT simonepalma contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT filippopesapane contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT samuelefrassoni contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT vincenzobagnardi contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT mariapizzamiglio contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT mariagiorgiafarina contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT chiaratrentin contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT silviapenco contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT lorenzameneghetti contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT claudiasangalli contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement AT enricocassano contrastenhancedspectralmammographyintheevaluationofbreastmicrocalcificationscontroversiesanddiagnosticmanagement |