The value of CESM in the evaluation of intraductal breast papilloma: a comparative study with DCE-MRI

Abstract

Background: The purpose of this study was to assess the accuracy of contrast-enhanced spectral mammography (CESM) as compared to dynamic contrast-enhanced MRI (DCE-MRI) in the evaluation of intraductal breast papilloma with histopathological correlation. This study is a retrospective study done on 45 consecutive patients. Their ages ranged between 36 and 70 years with a mean age of 51.1 ± 8.7. All of them were suspected to have intraductal papilloma on full-field digital mammography (FFDM), 3D automated breast ultrasound (3D-ABUS), and 2D handheld ultrasound (2DHHUS). CESM and DCE-MRI were done for all patients. The data were collected, tabulated, statistically analyzed using an IBM personal computer with Statistical Package of Social Science (SPSS). Results: There were 37 histopathology proven papillomas either by US-guided core needle biopsy, surgical biopsy following wire localization or fine-needle aspiration cytology (FNAC). Lesions are divided into three subgroups according to size. When the size of lesion > 10 mm MRI sensitivity and specificity is 100% and 66.7%, that of CESM is 90.1% and 0% respectively. In lesions sized 5–10 mm Sensitivity and specificity of MRI is 100% and 58% respectively and those of CESM are 63.6% and 50% respectively. Lesions less than 5mm MRI sensitivity and specificity is 100% and 0%, that of CESM was 0% and 100% respectively. Conclusion: DCE-MRI has a significantly higher sensitivity than CESM for the diagnosis of intraductal papilloma whatever the size of the lesion, especially when the size is less than 5 mm.