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Article

The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer

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Department of Oncological Surgery, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-514 Katowice, Poland
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Department of Radiology and Nuclear Medicine, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-514 Katowice, Poland
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Department of Pathomorphology and Molecular Diagnostics, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-752 Katowice, Poland
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Department of Orthopaedic and Trauma Surgery, District Hospital of Orthopaedics and Trauma Surgery, 41-940 Piekary Śląskie, Poland
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Department of Surgery, Ludwig Rydygier Hospital sp. z.o.o., 31-826 Kraków, Poland
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Students’ Scientific Society, Department of Radiology and Nuclear Medicine, Medical University of Silesia, 40-514 Katowice, Poland
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Department of Biochemistry and Medical Genetics, School of Health Sciences, Medical University of Silesia, 40-752 Katowice, Poland
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Department of Oncology and Radiotherapy, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-514 Katowice, Poland
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Authors to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(4), 2548-2559; https://doi.org/10.3390/curroncol28040232
Received: 20 May 2021 / Revised: 1 July 2021 / Accepted: 9 July 2021 / Published: 12 July 2021
(This article belongs to the Special Issue New Frontiers in Breast Cancer Diagnosis and Treatment)
Contrast-enhanced spectral mammography (CESM) is a promising, digital breast imaging method for planning surgeries. The study aimed at comparing digital mammography (MG) with CESM as predictive factors in visualizing multifocal-multicentric cancers (MFMCC) before determining the surgery extent. We analyzed 999 patients after breast cancer surgery to compare MG and CESM in terms of detecting MFMCC. Moreover, these procedures were assessed for their conformity with postoperative histopathology (HP), calculating their sensitivity and specificity. The question was which histopathological types of breast cancer were more frequently characterized by multifocality–multicentrality in comparable techniques as regards the general number of HP-identified cancers. The analysis involved the frequency of post-CESM changes in the extent of planned surgeries. In the present study, MG revealed 48 (4.80%) while CESM 170 (17.02%) MFMCC lesions, subsequently confirmed in HP. MG had MFMCC detecting sensitivity of 38.51%, specificity 99.01%, PPV (positive predictive value) 85.71%, and NPV (negative predictive value) 84.52%. The respective values for CESM were 87.63%, 94.90%, 80.57% and 96.95%. Moreover, no statistically significant differences were found between lobular and NST cancers (27.78% vs. 21.24%) regarding MFMCC. A treatment change was required by 20.00% of the patients from breast-conserving to mastectomy, upon visualizing MFMCC in CESM. In conclusion, mammography offers insufficient diagnostic sensitivity for detecting additional cancer foci. The high diagnostic sensitivity of CESM effectively assesses breast cancer multifocality/multicentrality and significantly changes the extent of planned surgeries. The multifocality/multicentrality concerned carcinoma, lobular and invasive carcinoma of no special type (NST) cancers with similar incidence rates, which requires further confirmation. View Full-Text
Keywords: breast cancer; contrast-enhanced spectral mammography; mammography; comparative studies; pathology; surgery breast cancer; contrast-enhanced spectral mammography; mammography; comparative studies; pathology; surgery
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MDPI and ACS Style

Lorek, A.; Steinhof-Radwańska, K.; Barczyk-Gutkowska, A.; Zarębski, W.; Paleń, P.; Szyluk, K.; Lorek, J.; Grażyńska, A.; Niemiec, P.; Gisterek, I. The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer. Curr. Oncol. 2021, 28, 2548-2559. https://doi.org/10.3390/curroncol28040232

AMA Style

Lorek A, Steinhof-Radwańska K, Barczyk-Gutkowska A, Zarębski W, Paleń P, Szyluk K, Lorek J, Grażyńska A, Niemiec P, Gisterek I. The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer. Current Oncology. 2021; 28(4):2548-2559. https://doi.org/10.3390/curroncol28040232

Chicago/Turabian Style

Lorek, Andrzej, Katarzyna Steinhof-Radwańska, Anna Barczyk-Gutkowska, Wojciech Zarębski, Piotr Paleń, Karol Szyluk, Joanna Lorek, Anna Grażyńska, Paweł Niemiec, and Iwona Gisterek. 2021. "The Usefulness of Spectral Mammography in Surgical Planning of Breast Cancer Treatment—Analysis of 999 Patients with Primary Operable Breast Cancer" Current Oncology 28, no. 4: 2548-2559. https://doi.org/10.3390/curroncol28040232

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