Multidetector Computed Tomography with Dedicated Protocol for Breast Cancer Locoregional Staging: Feasibility Study

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Locoregional staging is crucial for breast cancer management.
• Current staging methods can be resource-intensive.

Purpose of the Study:

• To assess the feasibility of multidetector computed tomography (MDCT) using a dedicated protocol for locoregional staging in breast cancer.
• To evaluate the agreement between MDCT, magnetic resonance imaging (MRI), and pathology for staging breast cancer.

Main Methods:

• Prospective single-center study involving newly diagnosed breast cancer patients.
• Contrast-enhanced chest MDCT in prone position with subtraction techniques was performed.
• Agreement assessed using Fleiss' Kappa (K) and intraclass correlation coefficients (ICC) compared to MRI and pathology.

Main Results:

• Substantial agreement between MDCT and MRI for tumor extension (K=0.674), multifocality (K=0.669), multicentricity (K=0.857), nipple invasion (K=1.000), and skin invasion (K=0.872).
• MDCT identified more suspicious axillary lymph nodes than MRI, particularly in levels II and III.
• Both MDCT and MRI showed similar correlations with pathology for tumor size and T staging.

Conclusions:

• MDCT with a dedicated breast protocol is feasible for staging breast cancer patients (Stage II/III).
• This technique demonstrates substantial agreement with MRI findings.
• MDCT offers potential for integrated locoregional and systemic staging, improving efficiency and reducing costs.