Preoperative contrast enhanced mammography evaluation of breast ductal carcinoma in situ and comparative analysis with pathological grading.

AIM: To assess the value of contrast-enhanced mammography (CEM) in the diagnosis of breast ductal carcinoma in situ (DCIS) and to analyse the correlation between the CEM manifestations and pathological nuclear grades of DCIS.

MATERIALS AND

METHODS

This single-center retrospective study included 190 patients with pure DCIS who underwent CEM within two weeks preoperatively. The CEM images of 196 DCIS lesions (bilateral DCIS in six patients) were reviewed to evaluate the diagnostic performance of CEM for DCIS with different nuclear grades.

RESULTS

CEM showed significantly higher sensitivity to DCIS (89.3%) than low-energy image alone (72.4%; P < .001), whether for calcified (96.8% vs. 91.2%; P = .016), noncalcified (76.1% vs. 39.4%; P < .001), low-grade (83.3% vs. 61.1%; P = .008), intermediate-grade (87.3% vs. 65.8%; P < .001) and high-grade DCIS (93.8% vs. 84.0%; P = .008). CEM was equally sensitive in diagnosing different grades of DCIS (P = .183). CEM was superior to low-energy image alone in showing the extent of DCIS lesions. In CEM, high-grade DCIS showed more calcifications and larger size than low-grade DCIS, and showed higher enhancement conspicuity than low- and intermediate-grade DCIS (P < .05). Low-grade DCIS showed less pleomorphic and fine linear branching calcifications than intermediate- and high-grade DCIS (P < .05). The three grading groups were not different in terms of enhancement percentage and enhancement morphology (P > .05).

CONCLUSIONS

CEM was superior to low-energy image alone in DCIS diagnosis. Different nuclear grades of DCIS manifested differently on CEM.