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Retrospective Comparison of Contrast-Enhanced Spectral Mammography with Digital Mammography in Assessing Tumor Size in 668 Cases of Breast Cancer

  • Lorek, Andrzej1
  • Steinhof-Radwańska, Katarzyna2
  • Barczyk-Gutkowska, Anna2
  • Zarębski, Wojciech1
  • Boratyn-Nowicka, Agnieszka3
  • Bobola, Agnieszka3
  • Lorek, Joanna4
  • Stojčev, Zoran1
  • Gisterek, Iwona5
  • 1 Department of Oncological Surgery, Medical University of Silesia in Katowice, Katowice, Poland
  • 2 Department of Radiology and Nuclear Medicine, Medical University of Silesia in Katowice, Katowice, Poland
  • 3 Department of Oncology, Medical University of Silesia in Katowice, Katowice, Poland
  • 4 Student of the Medical Faculty at the Medical University of Silesia in Katowice, Katowice, Poland
  • 5 Department of Oncology and Radiotherapy, Medical University of Silesia in Katowice, Katowice, Poland
Published Article
Medical Science Monitor
"International Scientific Information, Inc."
Publication Date
Sep 30, 2020
DOI: 10.12659/MSM.926977
PMID: 32994388
PMCID: PMC7534504
PubMed Central


Background Contrast-enhanced spectral mammography (CESM) is digital mammography with contrast agent. This promising new breast imaging method can be used for planning surgical treatment. This study compared CESM versus digital mammography (MG) in evaluating tumor size in breast cancer. Material/Methods Comparison of tumor dimensions in CESM, MG, and histopathology was made. The correlation of these data was assessed by histopathological type, biological subtype, grading of the carcinoma, and patient age. Results The average difference in tumor size between CESM and histopathological examination was 5 mm. The differences in size measurement between CESM and MG were significant (p=0.00). The Pearson’s linear correlation coefficients of CESM versus HP and MG versus HP were −0.01 (p=0.79) and −0.25 (p=0.00), respectively, indicating no differences between CESM and HP based on the lesion size. A weak negative correlation between those values was observed on MG. No relationship was found between the tumor size in CESM and the biological subtype, carcinoma malignancy degree, or patient age. Conclusions CESM is a new diagnostic method in breast cancer. The accuracy of measurement of tumor size using CESM is independent of lesion size, but it overestimates the size by 5 mm on average. The difference is not dependent on grading, biological subtype of the carcinoma, or patient age. They concern the histopathological type, and values are significantly greater in pre-invasive carcinomas.

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