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Clinical Imaging of Microwave Mammography
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Contrast-Enhanced Mammography vs. Breast MRI for Assessing Neoadjuvant Chemotherapy Response: A Prospective Clinical
Omer Acar1, Çağdaş Rıza Açar2, İhsan Sebnem Orguc2
1Department of Medical Oncology, Mardin Training and Research Hospital, Mardin 47200, Turkey.
Diagnostics (Basel, Switzerland)
|February 27, 2026
Summary
Contrast-enhanced mammography (CEM) shows comparable accuracy to breast MRI in assessing residual tumor size and pathological complete response after neoadjuvant chemotherapy (NAC). CEM offers a practical alternative, particularly when MRI is unavailable.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Neoadjuvant chemotherapy (NAC) is a standard treatment for breast cancer.
- Accurate assessment of treatment response is crucial for patient management.
- Breast MRI is the current standard for evaluating response to NAC.
Purpose of the Study:
- To compare contrast-enhanced mammography (CEM) with breast MRI.
- To evaluate residual tumor size and pathological complete response (pCR) after NAC.
- To determine if CEM is a viable alternative to MRI for response assessment.
Main Methods:
- Prospective study of 74 breast cancer patients receiving NAC.
- Patients underwent CEM and breast MRI before and after NAC.
- Residual tumor size and pCR were compared to histopathological findings.
Main Results:
- CEM estimated residual tumor size within ±1 cm of histopathology in 84.7% of cases, versus 76.4% for MRI.
- CEM showed higher sensitivity (91.3%) for predicting pCR than MRI.
- Agreement with histopathology was higher for CEM than MRI.
Conclusions:
- CEM performance is comparable to breast MRI in assessing NAC response.
- CEM demonstrates numerically higher sensitivity for predicting pCR.
- CEM is a practical and accessible alternative to MRI for response assessment.
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