When it comes to diagnosing breast cancer, which modality—contrast-enhanced mammography or dynamic contrast-enhanced breast magnetic resonance imaging—is more effective?
Radiologic Clinics published an article in July stating that it is dependent on a variety of factors, and the paper was quite informative.
Even though CEM performs marginally worse than MRI when it comes to breast cancer diagnostic imaging, colleagues Dr. Valentina Longo of Fondazione Policlinico Universitario in Rome and Dr. Ritse Mann, PhD, of Radboud University Medical Center in Nijmegen, the Netherlands, pointed out that in “many situations [it is] a viable alternative.”
Mammography is the most common way to screen for breast cancer.
Despite its limitations, the most notable of which is a diminished capacity to detect disease in thick breast tissue, mammography is the method that is being used.
Mammography has a number of limitations; however, ultrasonography is an alternative screening tool that can circumvent some of those limitations.
Nevertheless, the group made the observation that contrast-enhanced imaging, which provides functional information about the vascularity of the tumour, “strongly boosts the cancer detection rate in screening and also improves staging,” indicating that this imaging modality has the potential to be useful in the diagnosis of breast cancer.
Although contrast-enhanced mammography (CEM) was not available until 2011, dynamic contrast-enhanced breast MRI has been available since 1984.
CEM has been approved by the Food and Drug Administration (FDA) of the United States of America as an auxiliary modality for follow-up diagnostic testing for breast cancer; however, it has not been approved for screening purposes.
“CEM is mainly suggested as an alternative to MR imaging when MR imaging is not feasible for a patient,” according to the researchers Mann and Longo.
In addition to providing guidance on which of these contrast-enhanced treatments should be utilized in a certain clinical setting, the researchers also discussed some of the many benefits and drawbacks associated with each procedure:
Upon diagnosis of breast cancer,
Contrast-enhanced mammography (CEM) has been shown to have enhanced sensitivity (90.5% versus 52.4%) and decreased specificity (76.1% versus 90.5%) in comparison to regular mammography.
Based on earlier studies, the specificity of breast magnetic resonance imaging (MRI) can reach up to 98%, while its sensitivity can reach up to 100%. Nevertheless, this would suggest that the variable settings that were utilized in the process of calculating these statistics had to be taken into consideration.
Particularly well-visible on magnetic resonance imaging (MRI) are regions such as the axilla and far posterior locations, which are sometimes difficult to identify on mammography. The price, on the other hand, is significantly higher, and insurance might not always cover it.
According to the study participants, breast MRI is specifically recommended for very high-risk patients, such as carriers of the BRCA gene mutation, since they begin screening early in life and are more susceptible to radiation damage.
It will take contrast-enhanced microscopy (CEM) significantly longer to obtain images of the prepectoral and axillary breast regions than it does with breast magnetic resonance imaging (MRI).
Magnetic resonance imaging (MRI) of the breast is an extremely useful imaging technique for individuals who have had implants placed, since it allows an examination of the integrity of the implants.
Chemotherapy response evaluation using breast magnetic resonance imaging (MRI) is considered to be a regular practice.
Breast Cancer MRIs do not administer radiation.
What’s the last word? It is necessary to give some consideration to the selection of an imaging modality for the diagnosis of breast cancer.
“Factors to take into account when choosing between modalities include the likelihood of strong background parenchymal enhancement (that can be better managed with MR imaging), the importance of radiation (particularly relevant in young women), the availability of equipment, and women’s preferences (due to claustrophobia, compression, noise, and so forth),” according to the researchers Mann and Longo.
