title: Contrast-Enhanced Digital Mammography in the Surgical Management of Breast Cancer.
abstract: Contrast-enhanced digital mammography (CEDM) is a new breast imaging technique. The role of CEDM in the surgical management of breast cancer has not yet been characterized.
  
  
  
  A retrospective review of prospective breast surgery and breast imaging databases for patients who underwent CEDM and had breast cancer surgery.
  
  
  
  A total of 351 patients had CEDM; 128 had malignant lesions, and 101 of these underwent surgery with 105 malignancies identified. The mean age was 62 years (range 25-85 years). The histology was 65 % invasive ductal carcinoma, 16 % invasive lobular carcinoma, 11 % ductal carcinoma-in situ, 3 % mixed invasive ductal carcinoma/invasive lobular carcinoma, and 5 % other histologies. After excluding two lesions that had been removed before the examination, CEDM identified 98 % (n = 101/103) of the index lesions. The two lesions not identified were Paget disease only and a parasternal lesion too medial to include in the field of view. CEDM led to additional biopsies in 12 % (n = 12) of patients. Of these, 67 % (n = 8) proved to be invasive carcinoma and 33 % (n = 4) were benign. CEDM changed surgical management in 20 % (n = 20) of cancer patients with a 4 % (n = 4) rate of conversion to mastectomy.
  
  
  
  Among patients undergoing surgical therapy for breast cancer, CEDM was highly sensitive, had size measurements that correlated well with histologic size, and produced a relatively low rate of false-positive additional biopsy findings. CEDM appears to be promising as an alternative to magnetic resonance imaging in the surgical planning of these patients.
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ, USA. ali-mucheru.mariam@mayo.edu.
authors.forename: Mariam
authors.initials: M
authors.lastname: Ali-Mucheru
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Pockaj
authors.affiliation: Department of Radiology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Bhavika
authors.initials: B
authors.lastname: Patel
authors.affiliation: Department of Radiology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Pizzitola
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Nabil
authors.initials: N
authors.lastname: Wasif
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Chee-Chee
authors.initials: CC
authors.lastname: Stucky
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Gray
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000066491:Clinical Decision-Making; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media