Journal of Case Reports and Reviews in Medicine (ISSN: 3069-0749)
Research Article Volume: 2 & Issue: 3
Research Article Volume: 2 & Issue: 3
Characterization of breast lesions may remain uncertain with conventional imaging techniques, especially for suspected benign and low-suspicion lesions, which affect decisions about subsequent follow-up or diagnostic biopsy. This study is a cross-sectional diagnostic accuracy study to evaluate the role of Contrast-Enhanced Mammography (CEM) in identifying malignant lesions among 60 female patients aged 20-60 years who have BI-RADS category 3 or 4A lesions on conventional mammography or sonomammography or both. Dual-energy CEM was performed, followed by biopsy or surgical excision of lesions, and the results obtained on histopathology served as the reference standard. Histopathology revealed malignancy in ten of 60 patients (16.7%). CEM classified eleven lesions as malignant and forty-nine as non-malignant, with resulting true-positive, false-positive, false-negative and true-negative results of 9, 2, 1 and 48, respectively. The diagnostic accuracy of CEM, including sensitivity, specificity, PPV, NPV and accuracy rate, was calculated as 90%, 96%, 81.8%, 98% and 95%, respectively, with 95% confidence intervals (CI) for the detection of malignant lesions. CEM also showed positive and negative likelihood ratios of 22.5 and 0.10, respectively. This study demonstrates a high level of diagnostic capability of CEM, especially with a strong predictive power in ruling out malignancy in the studied population. Hence, CEM is considered to be a useful problem-solving tool for the evaluation of BI-RADS category 3 and 4A breast lesions.
Keywords: Breast Cancer; Contrast-Enhanced Mammography; Diagnostic Accuracy; BI-RADS; Breast Lesions; Histopathology.
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