TY - JOUR ID - 253181 TI - Assessment of Indeterminate Breast Lesions (Birads 4): Utility of Contrast Enhanced Mammography JO - The Medical Journal of Cairo University JA - MJCU LA - en SN - 0045-3803 AU - SHERINE K. AMIN, M.D., NERMIN F. GUERGIS, M.Sc.; AU - SUSAN A.A. ABDUL RAHIM, M.D., LOBNA A. HABIB, M.D.; AD - The Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University AD - Y1 - 2022 PY - 2022 VL - 90 IS - 6 SP - 815 EP - 822 KW - Contrast enhanced mammography (CEM) KW - Indeterminate breast lesions DO - 10.21608/mjcu.2022.253181 N2 - Abstract Background: Breast cancer is estimated to be the most common cancer among Egyptian females and accounts for the leading cause of cancer related mortality. Contrast enhanced mammography is an emerging technique that combines intra-venous iodinated contrast administration with digital mam-mography. CEM improves the sensitivity for breast cancer detection without decreasing the specificity owing to higher contrast and better lesion delineation. Aim of Study: To investigate the usefulness of contrast enhanced mammography in the assessment of indeterminate (BIRADS 4) breast lesions. Patients and Methods: The study was performed on 32 female patients discovered to have BIRADS 4 breast lesions on conventional mammography and/or breast ultrasonography. All patients were injected with non ionic contrast media. Examination was then performed on a digital mammography machine adapted for CESM. Results: CEM correctly upgraded 22/22 histopathologically proven malignant lesions from BIRADS 4 to 5. 18/22 benign lesions were correctly downgraded from BIRADS 4 to 3, while 4 benign lesions were incorrectly upgraded to a BIRADS 5 by CEM. No malignant lesions were incorrectly downgraded to BIRADS 3 by CEM. Overall performance of CEM was a sensitivity of 100%, a specificity of 81.8%, a PPV of 84.6%, a NPV of 100% and an accuracy of 90.9%. Conclusion: CEM is a useful and reliable tool that can increase diagnostic confidence when evaluating indeterminate breast lesions. UR - https://mjcu.journals.ekb.eg/article_253181.html L1 - https://mjcu.journals.ekb.eg/article_253181_100b6508805ae2e7494ecb3a6ef53f91.pdf ER -