Contrast-enhanced mammography (CEM)-guided biopsies: Initial experience at a tertiary cancer center
Michelle Lee1, Paola Tabaro2, Varadan Sevilimedu3
1Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, United States; Department of Radiology, New York University Grossman School of Medicine, New York, 10016, United States.
Purpose:
Contrast-enhanced mammography (CEM)-guided biopsy is an emerging technique with little data available. Our purpose is to determine the imaging features and predictors of malignancy for CEM-guided biopsies.
Methods:
IRB-approved, HIPAA-compliant search of our institutional database identified CEM-guided biopsies performed from January 1, 2023 to October 4, 2024. The electronic medical record, images, procedure and pathology reports were reviewed for patient demographics, biopsy target characteristics and available pathology. Descriptive statistics were performed.
Results:
53 CEM-guided biopsies were performed during the study period. The median patient age at biopsy was 50 years (range 34-87 years). The median biopsy target size was 1.2 cm (range 0.4-9.3). Biopsy targets included non-mass enhancement (36/53, 67.9%; average size 1.8 cm, range 0.4-7.0 cm), mass (14/53, 26.4%; average size 1.2 cm, range 0.4-4.3 cm), asymmetry (2/53, 3.8%; average size 2.2 cm, range 0.5-3.8 cm), and architectural distortion (1/53, 1.9%; size 9.3 cm). Fifteen of 53 (28.3%, 95% CI 17.6-41.9%) biopsied targets yielded malignancy, 4 of 53 (7.5%) yielded high-risk pathology, and 34 of 53 (64.2%) yielded benign pathology. One high-risk lesion and one benign discordant biopsy site yielded malignancy on excision. Post-biopsy hematomas occurred in two patients, none requiring intervention. No statistically significant predictors of malignancy were identified.
Conclusion:
In our single-institution study, CEM-guided biopsy is an effective technique to sample suspicious enhancing breast findings, yielding malignancy in a quarter of cases.
