Purpose: Palpable breast abnormalities in women warrant diagnostic evaluation. Contrast-enhanced spectral mammography (CESM) is a novel technique which has demonstrated early promising results in the diagnostic imaging setting. Our purpose was to evaluate the role of CESM for imaging of palpable breast abnormalities and compare it to the current routine imaging work-up.
Materials and Methods: We retrospectively analyzed data of women with palpable breast masses who underwent diagnostic CESM and US between 2012-2019. We calculated and compared the diagnostic parameters for low-energy images as standard mammography, CESM and targeted ultrasound.
Results: Of 138 women included in the analysis, 40 had malignant lesions. Standard 2D mammography revealed 36/40 cancers (sensitivity 90%). All 40 cancers (100%) were detected on CESM and on targeted ultrasound. Negative predictive value for 2D mammography was 95.1% (78/82), and 100% for both US (62/62) and for CESM (68/68). None of the palpable lesions that were negative on CESM but positive on US (n=14) were malignant.
Conclusion: CESM could be useful for assessment of palpable breast abnormalities, potentially decreasing the number of unnecessary benign biopsies performed.
