Introduction: Breast cancer screening decreases mortality and enables early diagnosis of breast cancer. Mammography is the only modality approved for breast cancer screening. Yet, mammography is limited in women with dense breasts. Contrast-enhanced mammography is a new imaging modality.
Objectives: The aim of this study was to evaluate the diagnostic performance of contrast-enhanced mammography for breast cancer screening in women with dense breasts and intermediate breast cancer risk. The study strives to compare the diagnostic performance of contrast-enhanced mammography to standard digital mammography in women with intermediate-risk and dense breasts.
Methods: A retrospective cohort of 270 consecutive women who underwent screening with contrast mammography between the years 2015-2016. BI-RADS scores of both conventional and contrast-enhanced mammography were compared with the actual disease status, assessed by histopathology or imaging follow-up. Sensitivities, specificities, positive and negative predictive values were calculated.
Results: Conventional mammography detected 7 out of 11 breast cancers, with sensitivity of 63.6%, specificity 91.1%, positive predictive value 23.3% and negative predictive value of 98.3%. Contrast-enhanced mammography detected 10 out of 11 cancers. Sensitivity was 90.9%, specificity 70.7%, positive predictive value 11.6%, and negative predictive value 99.4.
Conclusions: Contrast-enhanced mammography was more sensitive than digital mammography at detecting breast cancer in women with dense breasts and intermediate breast cancer risk.
Discussion: The technological development in breast imaging can be part of personalized medicine including contrast mammography for women with intermediate risk. Contrast mammography can be the screening examination for women with dense breasts and intermediate risk.