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116249

Diagnosis of Breast Micro calcifications with Contrast Enhanced Digital Mammography and Histopathological Correlation

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Last updated: 22 Jan 2023

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Abstract

Abstract Backgroud: Microcalcificaitons constitute up to 31% of lesions detected at screening mammography. Ductal carcinoma in situ (DCIS) often presents with microcalcificaitons on mammography. Of all mammographically detected DCIS lesions, up to 79% manifest with microcalcifications only. However, not all microcalficications are associated with in situ or malignant disease. Aim of Study: To evaluate diagnostic value of contrast enhanced digital mammography in breast microcalcificaations. Methods: A retrospective study of 30 patients having mammographic suspicious breast calcifications under BIRADS 4, 5 and 6 categories. A high-energy and a low-energy digital mammograms were obtained and then images were subtracted, isolating the iodine signal in the region of angiogenesis. 1.5mg/kg of the contrast agent was injected by hand over a period of 1 minute at a rate of 3mL per second, followed by a saline solution flush. Breast compression was applied to reduce the thickness of the breast and images obtained exactly 2 min after contrast administration. Image acquisitions: Cranio-caudal and the medio-lateral oblique projections for the abnormal breast were obtained exactly 2 minutes after contrast injection followed by cranio-caudal and medio-lateral oblique projections of the normal breast. The lesions were analyzed by specialized radiologist for the presence, morphology, and pattern of enhancement. Finally, Correlation with histopatho-logical findings was done. Results: The sensitivity of CEDM in detecting malignant pathology with contrast uptake was 96%. Compared to sensi-tivity of 86.7% in FFDM. There were lesions of IDC in (69.2%), lesion of DCIS in (11.5%), lesion of IDCS & IDC in (11.5%) and lesions of ILC in (3.8%). Enhancement was also observed in 3/4 (75%) of the benign lesions. Conclusion: Dual-energy contrast-enhanced digital mam-mography is a useful technique in the diagnosis of underlying disease in mammographically detected breast microcalcifica-tions.

DOI

10.21608/mjcu.2020.116249

Keywords

Microcalcifications, contrast enhanced digital mammography, Ductal carcinoma insitu

Authors

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HANA HAMDY NASSEF, M.D.;

Last Name

AMIR LOUIS LOUKA, M.D.

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AMIRA

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LOTAIF ABDULLAH, M.Sc.

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Affiliation

The Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University

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Volume

88

Article Issue

September

Related Issue

14147

Issue Date

2020-09-01

Receive Date

2020-06-30

Publish Date

2020-09-01

Page Start

1,561

Page End

1,569

Print ISSN

0045-3803

Online ISSN

2536-9806

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https://mjcu.journals.ekb.eg/article_116249.html

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https://mjcu.journals.ekb.eg/service?article_code=116249

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Original Article

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263

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Journal

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The Medical Journal of Cairo University

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https://mjcu.journals.ekb.eg/

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Article

Created At

22 Jan 2023