Topic: The Effective Combination of Mammography and Ultrasound for Preop Staging
Studies have shown that a contrast-enhanced mammography paired with an ultrasound is an effective combination when it comes to preoperative staging for breast cancer. More specifically, this combination was shown to be equally as effective as a breast MRI for preoperative staging.
Studying the Effectiveness of a Mammography and Ultrasound
The effectiveness of a contrast-enhanced mammography combined with an ultrasound was confirmed due to a Dutch study. This study was published in the European Journal of Radiology on August 2nd and showed the combination was effective and allowed breast cancer patients to receive everything they needed in one appointment instead of scheduling a breast MRI.
The goal of preoperative imaging is for health experts to assess the extent of the cancer, as well as to stage treatment. Since contrast-enhanced mammography has been determined to be more accurate than traditional mammography, it now rivals a breast MRI and is cheaper to perform. Like a breast MRI, it is able to measure the size of tumors. Furthermore, it has fewer false-positive findings due to its specificity.
In regard to axillary ultrasound, the study reported an equal performance when compared with an evaluation of the axilla on a standard breast MRI, making it a great alternative and something that can be performed on the same day as the contrast-enhanced mammography.
In fact, a study conducted previously reported that a breast MRI had the potential to slightly overestimate the size of a tumor and a contrast-enhanced mammography did not, making it an equal if not preferable choice. Furthermore, researchers asserted that there is no current evidence that supports receiving a supplemental breast MRI provides an advantage when assessing the axillary lymph nodes if an ultrasound was already conducted.
The Potential Downside and Exceptions
Though the combination proves promising, there is a potential downside when it comes to pairing a contrast-enhanced mammography with an ultrasound. Specifically, there is the potential to miss internal mammary lymph node metastases because mammographic images do not capture the field of view necessary to detect them.
In addition, there are a few exceptions when it comes to the consideration of not performing a breast MRI in terms of preoperative staging. For example, patients with breast implants, lobular cancer, an allergy for iodinated contrast agents, renal insufficiency, or breast legions may still benefit from receiving a breast MRI. However, for many patients, the combination of contrast-enhanced mammography and an ultrasound remains quite effective.
Key Takeaway
A single-appointment strategy for breast cancer patients is to receive a contrast-enhanced mammography and ultrasound when it comes to preoperative staging. Studies have shown this is an equally effective method to receiving a breast MRI and has the advantages of not having to schedule an additional appointment and saving on costs. However, there are specific instances where patients may still need to receive a breast MRI, so it is best to consult with health experts first.
Discussed Topic: The Effective Combination of Mammography and Ultrasound for Preop Staging
