The use of contrast-enhanced spectral mammography in monitoring neoadjuvant treatment of breast cancer: a clinical case study
Karacharova I.Yu.1, Malets M.S.1, Gurando A.V.2, Starenkyi V.P.3
- 1Kyiv City Clinical Oncology Center, Kyiv, Ukraine
- 2P.L. Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
- 3S.P. Grigoriev Institute for Medical Radiology and Oncology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
Summary. Contrast-enhanced mammography (CEM) is the latest method of breast diagnosis in the world. Its uniqueness lies in the combination of low-energy breast imaging, identical to standard mammography, with the possibility of combining it with tomosynthesis, and high-energy breast imaging. The software generates a contrast image by combining low-energy and high-energy images. In terms of information content, it is comparable to magnetic resonance imaging (MRI) of the breast and is based on a similar method of contrast fixation in tissues. That is why CEM is highly valuable and informative in the diagnosis of breast cancer (BC) and is widely used worldwide for local staging and monitoring of neoadjuvant treatment of BC. According to statistics from the World Health Organization (WHO), BC is the most common type of cancer in the world. In Ukraine, it ranks first among malignant neoplasms (MN) amids the female population. This article presents a clinical case of a 45-year-old woman with multifocal cancer of the right breast with metastases to the right axillary lymph nodes. During her initial visit at the diagnostic stage, she underwent CEM to determine the number of masses and their spread in the breast. In order to adequately assess the effectiveness of neoadjuvant treatment, monitoring was performed using CEM after 4 and 8 courses of neoadjuvant chemotherapy (NAC). Using this clinical case as an example, we describe the algorithms for performing CEM, its advantages, limitations, and certain artifacts, justify the reasons for its use in this clinical case, analyze the results of the images obtained, and correlate them with the pathomorphological results. Conclusions are also made regarding the feasibility of using this study as a tool in the local staging of BC and at the stage of monitoring neoadjuvant treatment. The importance of a multimodal approach to the diagnosis of BC is accentuated, with an emphasis on patient-centered care and adherence to standardized diagnostic protocols to achieve safe and effective results while avoiding false conclusions.
Leave a comment