Are All Views with and without Displacement Maneuver Necessary in Augmentation Mammography? Putting Numbers Into...

Area of Science:

• Radiology
• Medical Imaging
• Breast Imaging

Background:

• Augmentation implants present unique challenges in mammographic interpretation.
• Standard mammography views may obscure underlying breast tissue when implants are present.

Purpose of the Study:

• To assess the agreement between standard craniocaudal (CC) and mediolateral oblique (MLO) mammographic views and those with implant displacement (CC-ID, MLO-ID).
• To evaluate inter- and intraobserver agreement in identifying abnormal mammographic findings in women with breast implants.

Main Methods:

• 360 women with breast implants underwent mammography with standard and implant displacement views.
• Three readers assessed mammograms for BI-RADS® outcomes (normal/abnormal).
• Kappa index was used to compare CC/CC-ID and MLO/MLO-ID views, and assess reader agreement.

Main Results:

• Implant displacement views identified more abnormalities: CC-ID (18.8%) vs. CC (10.8%), and MLO-ID (15.8%) vs. MLO (10.5%).
• CC-ID views singly identified the most abnormal findings (23%).
• Inter- and intraobserver agreement were substantial (Kappa values 0.67 and 0.74, respectively).

Conclusions:

• All mammographic views, including those with implant displacement, are necessary for detecting breast abnormalities in women with augmentation implants.
• The study demonstrated substantial inter- and intraobserver agreement, supporting the reliability of these methods.