Chou Chen-Pin, Hong Yu-Ting, Lin Yun, Lin Pei-Ying
Radiology Department, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung, Taiwan, ROC.
Heliyon. 2025 Jan 10;11(2):e41851. doi: 10.1016/j.heliyon.2025.e41851. eCollection 2025 Jan 30.
To assess the diagnostic performance of contrast-enhanced mammography (CEM) in screening higher-risk Taiwanese women for breast cancer.
We conducted a prospective study at a Taiwanese medical center from 2019 to 2021. The study compared imaging techniques for breast cancer screening in women with a personal history of precancer or cancer, or a family history (first-degree relatives). The study included breast ultrasound (US) and the CEM combo, which consists of digital mammography (DM), digital breast tomosynthesis (DBT), and CEM. Diagnostic accuracy was compared using the receiver operating characteristic (ROC) curve.
The study included 308 women, average age 52.1, with 86 % having familial breast cancer history and 14 % personal breast cancer or pre-cancerous histories. Approximately 19.5 % had lesions rated BI-RADS 4 or 5. Biopsies were performed on 56 women based on lesions detected by the CEM combo. Additionally, 60 biopsies were due to abnormalities found via DM or DBT (n = 20) or US (n = 40). Breast cancer was confirmed in 8 women post-biopsy. The CEM combo showed a sensitivity of 87.5 %, significantly higher than DM (50 %), DBT (50 %), and US (25 %). The ROC curve area for CEM was 0.85, outperforming DM (0.65), DBT (0.63), and US (0.55), with all comparisons statistically significant (p < 0.05). Lesions detected solely by DM, DBT, or US did not yield any cancer cases.
CEM effectively detects breast cancer in higher-risk Taiwanese women, but further research is needed to refine biopsy recommendations.
评估对比增强乳腺X线摄影（CEM）在筛查台湾高危女性乳腺癌中的诊断性能。
2019年至2021年，我们在台湾一家医疗中心进行了一项前瞻性研究。该研究比较了有癌前病变或癌症个人史或家族史（一级亲属）的女性乳腺癌筛查的成像技术。研究包括乳腺超声（US）和CEM组合，后者由数字乳腺X线摄影（DM）、数字乳腺断层合成（DBT）和CEM组成。使用受试者操作特征（ROC）曲线比较诊断准确性。
该研究纳入了308名女性，平均年龄52.1岁，其中86%有家族性乳腺癌病史，14%有个人乳腺癌或癌前病史。约19.5%的人病变评级为BI-RADS 4或5。基于CEM组合检测到的病变，对56名女性进行了活检。此外，60次活检是由于通过DM或DBT（n = 20）或US（n = 40）发现的异常。活检后8名女性被确诊为乳腺癌。CEM组合的敏感性为87.5%，显著高于DM（50%）、DBT（50%）和US（25%）。CEM的ROC曲线面积为0.85，优于DM（0.65）、DBT（0.63）和US（0.55），所有比较均具有统计学意义（p < 0.05）。仅通过DM、DBT或US检测到的病变未产生任何癌症病例。
CEM能有效检测台湾高危女性的乳腺癌，但需要进一步研究以完善活检建议。
