Can positron emission mammography help to identify clinically significant breast cancer in women with suspicious calcifications on mammography?
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To evaluate the diagnostic accuracy of positron emission mammography (PEM) for identifying malignant lesions in patients with suspicious microcalcifications detected on mammography.
A prospective, single-centre study that evaluated 40 patients with suspicious calcifications at mammography and indication for percutaneous or surgical biopsy, with mean age of 56.4 years (range: 28-81 years). Patients who agreed to participate in the study underwent PEM with 18F-fluorodeoxyglucose before the final histological evaluation. PEM findings were compared with mammography and histological findings.
Most calcifications (n = 34; 85.0 %) were classified as BIRADS 4. On histology, there were 25 (62.5 %) benign and 15 (37.5 %) malignant lesions, including 11 (27.5 %) ductal carcinoma in situ (DCIS) and 4 (10 %) invasive carcinomas. On subjective analysis, PEM was positive in 15 cases (37.5 %) and most of these cases (n = 14; 93.3 %) were confirmed as malignant on histology. There was one false-positive result, which corresponded to a fibroadenoma, and one false negative, which corresponded to an intermediate-grade DCIS. PEM had a sensitivity of 93.3 %, specificity of 96.0 % and accuracy of 95 %.
PEM was able to identify all invasive carcinomas and high-grade DCIS (nuclear grade 3) in the presented sample, suggesting that this method may be useful for further evaluation of patients with suspected microcalcifications.
• Many patients with suspicious microcalcifications at mammography have benign results at biopsy.
• PEM may help to identify invasive carcinomas and high-grade DCIS.
• Management of patients with suspicious calcifications can be improved.
KeywordsBreast neoplasms Carcinoma ductal in situ Mammography Fluorodeoxyglucose F18 Positron emission tomography
- 95 % CI
95 % confidence interval
area under the curve
Breast Imaging Report and Data System
ductal carcinoma in situ
lesion to background
negative predictive value
Positron emission mammography
Positron emission tomography/computed tomography
positive predictive value
PEM uptake value
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