Diagnostic accuracy of contrast-enhanced mammography vs MRI in evaluating the response of breast cancer treated with neoadjuvant chemotherapy

Introduction: Magnetic resonance imaging is the most accurate diagnostic method for evaluating residual disease in breast cancer treated with neoadjuvant chemotherapy. Contrast-enhanced mammography can be an effective alternative to MRI in the evaluation of residual tumor. This technique would significantly reduce costs, improve patient flow and hardly has any contraindications. Methods: We have carried out an observational and prospective study in 43 patients with breast cancer treated with neoadjuvant chemotherapy. The pre-surgical study included both mammography with contrast injection and magnetic resonance imaging. Residual tumor size by imaging was correlated with the postoperative pathology study. Results: The CM presents a higher interclass correlation coefficient than the RM (0.9 vs. 0.7). The sensitivity and specificity values of CM (83.9% and 83.3%) are high and comparable to those of MRI (74.2% and 91.6%). Furthermore, the negative predictive value of CM is greater than that of MRI (66.7% vs 57.9%) and PPV is very similar (92.9% vs 95.8%). Conclusion: Contrast-enhanced mammography is a test comparable to magnetic resonance imaging for the evaluation of post-neoadjuvant tumor response in patients with breast cancer. It is also a valid test in visualizing additional lesions in the same or contralateral breast. n 2022 SESPM. Published by Elsevier Espana, S.L.U. All rights reserved.