Diagnostic Accuracy of Contrast Enhanced Spectral Mammography in Assessment of Indeterminate Breast Lesions in Patients after Breast Conservation Surgery

Abstract Background Breast cancer in women represents a major public health problem being the most common cancer among women in both developed and developing countries, it accounts for 22.9% of all new female cancers. In Egypt breast cancer accounts for 37.7% of the total new cancer cases. Contrast Enhanced Spectral Mammography (CESM) is an emerging advanced technique that depicts breast tumor angiogenesis. CESM has higher diagnostic accuracy compared to MG with or without US and can depict tumor neovascularity in an analogue manner to breast MRI. Aim of Work To evaluate the diagnostic accuracy of contrast enhanced spectral digital mammography in assessment of indeterminate breast lesions in patients after breast conservation surgery. Patients and Methods 30 female patients underwent breast conservative surgery presenting with indeterminate breast lesion on mammography had been evaluated by dual-energy contrast enhanced spectral mammography. The age ranged from 32 to 77 years (mean=50.07). Results of histopathological examinations of surgical or biopsy specimens were obtained and served as the gold standard. Results The surgical and pathological results of our patients revealed 23/33 (69.7%) benign lesions and 10/33 (30.3% malignant lesions. CESM had a sensitivity of 88.9%, a specificity of 83.3%, a positive predictive value of 66.7%, a negative predictive value of 95.2%. Conclusion CESM is a promising tool for increasing the sensitivity and the diagnostic accuracy of conventional mammography in follow-up of patients with breast conservative surgery.