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10.06.2020 | Breast

Breast-specific gamma imaging or ultrasonography as adjunct imaging diagnostics in women with mammographically dense breasts

verfasst von: Zhigang Zhang, Weilan Wang, Xiaochen Wang, Xiuyan Yu, Ying Zhu, Hongwei Zhan, Zhigang Chen, Baizhou Li, Jian Huang

Erschienen in: European Radiology | Ausgabe 11/2020

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Abstract

Background

Mammography (MMG) shows decreased diagnostic accuracy in dense breast tissue, and thus, ultrasonography (US) and breast-specific gamma imaging (BSGI) have gradually been adopted for women with mammographically dense breasts. However, these two adjunct modalities have not been directly compared in previous studies. Hence, we investigated the adjunctive efficacy of US and BSGI in mammographically dense breasts.

Methods

This retrospective, comparative study recruited women with mammographically dense breasts. All enrolled women underwent US and BSGI as adjunctive imaging, and the comparative sensitivity, specificity, and diagnostic accuracy of combined MMG plus BSGI versus MMG plus US were evaluated. McNemar’s test was used for paired binary data in this comparative analysis.

Results

From April 2013 to April 2016, 364 women with mammographically dense breasts and a final surgical or biopsy pathological diagnosis were recruited, comprising 218 cases of malignant disease (59.9%) and 146 cases of benign disease (40.1%). There was no difference between BSGI and US in enhancing the sensitivity of MMG diagnosis (Se-Difference 3.2%, p = 0.23), but the diagnostic specificity of MMG plus BSGI was superior to that of MMG plus US (Sp-Difference 10.3%, p = 0.003). The area under the ROC curve showed that MMG plus BSGI had better diagnostic accuracy than MMG plus US (0.90 vs. 0.83, p = 0.0019).

Conclusions

For women with mammographically dense breasts, MMG plus BSGI or US can improve the diagnostic accuracy. In addition, BSGI has high specificity and could reduce invasive biopsies and thus may represent a viable diagnostic imaging alternative for mammographically dense breasts.

Key Points

• Both BSGI and US can be applied as adjunct imaging diagnostics in women with mammographically dense breasts.

• The diagnostic accuracy of MMG plus BSGI was higher than that of MMG plus US.

• BSGI has the potential to be used as an adjunct diagnostic modality in women with mammographically dense breasts.

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Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA Cancer J Clin 69:7–34CrossRef

Fan L, Strasser-Weippl K, Li J-J et al (2014) Breast cancer in China. Lancet Oncol 15:e279–e289CrossRef

Welch HG, Prorok PC, O'Malley AJ, Kramer BS (2016) Tumor size, overdiagnosis, and mammography screening effectiveness. N Engl J Med 375:1438–1447

Pike MC, Pearce CL (2013) Mammographic density, MRI background parenchymal enhancement and breast cancer risk. Ann Oncol 24(Suppl 8):viii37–viii41CrossRef

Rice MS, Bertrand KA, VanderWeele TJ et al (2016) Mammographic density and breast cancer risk: a mediation analysis. Breast Cancer Res 18:94

Oeffinger KC, Fontham ET, Etzioni R et al (2015) Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA 314:1599–1614CrossRef

Shen S, Zhou Y, Xu Y et al (2015) A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women. Br J Cancer 112:998–1004CrossRef

Ohuchi N, Suzuki A, Sobue T et al (2016) Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancer in the Japan Strategic Anti-cancer Randomized Trial (J-START): a randomised controlled trial. Lancet 387:341–348CrossRef

Brem RF, Ruda RC, Yang JL, Coffey CM, Rapelyea JA (2016) Breast-specific -imaging for the detection of mammographically occult breast cancer in women at increased risk. J Nucl Med 57:678–684CrossRef

10.

Sun Y, Wei W, Yang HW, Liu JL (2013) Clinical usefulness of breast-specific gamma imaging as an adjunct modality to mammography for diagnosis of breast cancer: a systemic review and meta-analysis. Eur J Nucl Med Mol Imaging 40:450–463CrossRef

11.

Choi EK, Im JJ, Park CS, Chung YA, Kim K, Oh JK (2018) Usefulness of feature analysis of breast-specific gamma imaging for predicting malignancy. Eur Radiol 28:5195–5202CrossRef

12.

Yu X, Hu G, Zhang Z et al (2016) Retrospective and comparative analysis of 99mTc-Sestamibi breast specific gamma imaging versus mammography, ultrasound, and magnetic resonance imaging for the detection of breast cancer in Chinese women. BMC Cancer 16

13.

D’Orsi CJSE, Mendelson EB, Morris EA et al (2013) ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. American College of Radiology, Reston

14.

DeLong ERDD, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845CrossRef

15.

Rajaram N, Mariapun S, Eriksson M et al (2016) Differences in mammographic density between Asian and Caucasian populations: a comparative analysis. Breast Cancer Res Treat 161:353–362CrossRef

16.

Hendrick RE, Tredennick T (2016) Benefit to radiation risk of breast-specific gamma imaging compared with mammography in screening asymptomatic women with dense breasts. Radiology 281:583–588

17.

Hildebrandt MG, Gerke O, Baun C et al (2016) [18F]Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in suspected recurrent breast cancer: a prospective comparative study of dual-time-point FDG-PET/CT, contrast-enhanced CT, and bone scintigraphy. J Clin Oncol 34:1889–1897CrossRef

18.

Kuhl CK, Schrading S, Bieling HB et al (2007) MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet 370:485–492CrossRef

19.

Brem RF, Ioffe M, Rapelyea JA et al (2009) Invasive lobular carcinoma: detection with mammography, sonography, MRI, and breast-specific gamma imaging. AJR Am J Roentgenol 192:379–383CrossRef

20.

Mandelson MTON, Porter PL, White D, Finder CA, Taplin SH, White E (2000) Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst 92:1081–1087CrossRef

21.

Berg WA, Blume JD, Cormack JB et al (2008) Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 299:2151–2163

22.

Tan H, Zhang H, Yang W et al (2016) Breast-specific gamma imaging with Tc-99m-sestamibi in the diagnosis of breast cancer and its semiquantitative index correlation with tumor biologic markers, subtypes, and clinicopathologic characteristics. Nucl Med Commun 37:792–799CrossRef

23.

Rechtman LR, Lenihan MJ, Lieberman JH et al (2014) Breast-specific gamma imaging for the detection of breast cancer in dense versus nondense breasts. AJR Am J Roentgenol 202:293–298CrossRef

24.

Holbrook A, Newel MS (2015) Alternative screening for women with dense breasts: breast-specific gamma imaging (molecular breast imaging). AJR Am J Roentgenol 204:252–256CrossRef

25.

Goldsmith SJ, Parsons W, Guiberteau MJ et al (2010) SNM practice guideline for breast scintigraphy with breast-specific gamma-cameras 1.0. J Nucl Med Technol 38:219–224CrossRef

Titel: Breast-specific gamma imaging or ultrasonography as adjunct imaging diagnostics in women with mammographically dense breasts
verfasst von: Zhigang Zhang
Weilan Wang
Xiaochen Wang
Xiuyan Yu
Ying Zhu
Hongwei Zhan
Zhigang Chen
Baizhou Li
Jian Huang
Publikationsdatum: 10.06.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 11/2020
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-06950-2

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Breast-specific gamma imaging or ultrasonography as adjunct imaging diagnostics in women with mammographically dense breasts