Comparative study of Adjunct Imaging Modalities in Dense breast (AdMoB-D study)

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Dense breast tissue can obscure cancer on standard mammograms.
• Accurate breast cancer detection in dense breasts remains a clinical challenge.

Purpose of the Study:

• To compare the diagnostic accuracy of contrast-enhanced mammography (CEM) against digital mammography (DM), digital breast tomosynthesis (DBT), and ultrasonography (USG).
• To evaluate the effectiveness of CEM for breast cancer detection specifically in patients with dense breasts.

Main Methods:

• A prospective study involving 100 females with ACR C or D density.
• Imaging findings assessed using ACR BI-RADS; histopathology served as the reference standard.
• Calculated sensitivity, specificity, predictive values, ROC analysis, and kappa statistics.

Main Results:

• CEM exhibited the highest sensitivity (97.9%) and negative predictive value (NPV) (97.7%), outperforming DM and DBT (p < 0.001).
• In the diagnostic cohort, CEM achieved 100% sensitivity and identified additional disease in 12 patients.
• CEM demonstrated higher specificity (94.3%) and the strongest agreement with histopathology (κ 0.80).

Conclusions:

• CEM shows superior diagnostic accuracy in dense breasts compared to conventional mammographic techniques.
• CEM enhances cancer detection and disease extent assessment, supporting its role as a valuable adjunct, especially in resource-limited settings.