The Brilliance of Contrast Enhanced Spectral Mammography
Laurence Gluch MB.BCh PhD, Marie
Sahyoun BAppSc, MHSc and Timothy
Mander Jones MB.BS, RANZCR
Correspondence Address :
Strathfield Breast Centre
3 Everton Road, Strathfield
Received on: December 19, 2019, Accepted on: December 30, 2019, Published on: January 03, 2020
Citation: Laurence Gluch , Marie Sahyoun and Timothy Mander Jones (2019). The Brilliance of Contrast Enhanced Spectral Mammography.
Copyright: 2019 Laurence Gluch, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Problem Statement: Breast MRI is considered the gold standard in delineating breast cancer extent. However, MRI is rarely used for breast examination due to poor availability and cost. Contrast Enhanced Spectral Mammography (CESM) has been shown to offer higher sensitivity and greater diagnostic accuracy than conventional mammography in breast cancer imaging. Breast cancers have a higher avidity to take up contrast than normal tissue. This has enabled us to demonstrate tumour extent comparable to that offered by contrast enhanced breast MRI.
Methods: Following review of initial mammogram and ultrasound images CESM was requested as it was thought this may add spatial information of clinical usefulness to the referring surgeon.
Results: CESM was able to demonstrate both invasive cancer and ductal carcinoma in-situ (DCIS), and was of particular usefulness in dense breasts. We were able to identify satellite tumour nodules that had not been appreciated on conventional imaging. On occasion CESM was able to demonstrate that cancers contained within denser breast parenchymal areas were actually quite discrete, allowing for smaller, rather than wider, tumour resections. This afforded greater confidence in planning definitive surgery.
Conclusion: CESM offers a quick, affordable and readily available alternate to MRI to obtain high resolution, anatomically precise image characterisation of breast cancers and can be readily integrated into a conventional mammographic imaging service.
Keywords: Breast cancer, Breast imaging, Mammography, Contrast mammography, CESM