07 Dec Contrast-enhanced mammography significantly improved detection of early breast cancer in women with Personal History of Breast Cancer
MedicalResearch.com Interview with:
Wendie Berg, MD, PhD, FACR
Professor of Radiology
University of Pittsburgh
MedicalResearch.com: What is the background for this study?
Response: Mammography misses many cancers in women with a personal history of breast cancer (PHBC). MRI improves early detection of cancer in women with PHBC and the American College of Radiology recommends adding MRI every year for women with PHBC and dense breasts or diagnosis by age 50 but not every woman can tolerate MRI.
Contrast-enhanced mammography (CEM) appears to be a good alternative to MRI. Our study examined performance of CEM after tomosynthesis in women with PHBC. We first trained our radiologists in CEM (Berg WA et al JBI 2021) and two radiologists interpreted both tomosynthesis and CEM on every participant.
MedicalResearch.com: What are the main findings?
Response: Contrast-enhanced mammography significantly improves detection of early breast cancer in women with PHBC, adding 7/1000 when reviewed by one radiologist and 9/1000 when reviewed by two radiologists. This benefit seems to persist each year, though these results are preliminary for incidence screens. The benefit was similar in women with scattered fibroglandular tissue or heterogeneously dense breasts. The added recall rate was about 6% in the first year and about 4% in the second year.
MedicalResearch.com: What should readers take away from your report?
Response: Contrast-enhanced mammography seems to be a good alternative to MRI for women with a personal history of breast cancer.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: We need to continue our study to truly verify the yield from annual incidence screening. As more and more centers start to implement CEM in clinical practice, it will be very important to monitor outcomes. Results are likely different in different patient populations, but women with PHBC are particularly appropriate for supplemental screening beyond tomosynthesis.
I am grateful to The Breast Cancer Research Foundation for support and to my colleagues for all their efforts. I disclose research support to my Department (for which I am the PI) from Koios Medical, Inc. I am voluntary Chief Scientific Advisor for DenseBreast-info.org.
Citation: RSNA 2022 abstract
Improving Surveillance of Women with Personal History of Breast Cancer Using Tomosynthesis or Contrast-Enhanced Mammography (TOCEM) presented at RSNA 2022 11/27/2022
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