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Addition of Contrast-enhanced Mammography to Tomosynthesis for Breast Cancer Detection in Women with a Personal History of Breast Cancer: Prospective TOCEM Trial Interim Analysis.
Berg, Wendie A; Berg, Jeremy M; Bandos, Andriy I; Vargo, Adrienne; Chough, Denise M; Lu, Amy H; Ganott, Marie A; Kelly, Amy E; Nair, Bronwyn E; Hartman, Jamie Y; Waheed, Uzma; Hakim, Christiane M; Harnist, Kimberly S; Reginella, Ruthane F; Shinde, Dilip D; Carlin, Bea A; Cohen, Cathy S; Wallace, Luisa P; Sumkin, Jules H; Zuley, Margarita L.
Afiliação
  • Berg WA; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Berg JM; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Bandos AI; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Vargo A; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Chough DM; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Lu AH; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Ganott MA; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Kelly AE; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Nair BE; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Hartman JY; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Waheed U; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Hakim CM; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Harnist KS; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Reginella RF; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Shinde DD; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Carlin BA; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Cohen CS; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Wallace LP; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Sumkin JH; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
  • Zuley ML; From the Departments of Radiology (W.A.B., A.V., D.M.C., A.H.L., M.A.G., A.E.K., B.E.N., J.Y.H., U.W., C.M.H., K.S.H., R.F.R., D.D.S., B.A.C., C.S.C., L.P.W., J.H.S., M.L.Z.) and Computational and Systems Biology (J.M.B.), University of Pittsburgh School of Medicine, 300 Halket St, Pittsburgh, PA 15
Radiology ; 311(1): e231991, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38687218
ABSTRACT
Background Digital breast tomosynthesis (DBT) is often inadequate for screening women with a personal history of breast cancer (PHBC). The ongoing prospective Tomosynthesis or Contrast-Enhanced Mammography, or TOCEM, trial includes three annual screenings with both DBT and contrast-enhanced mammography (CEM). Purpose To perform interim assessment of cancer yield, stage, and recall rate when CEM is added to DBT in women with PHBC. Materials and Methods From October 2019 to December 2022, two radiologists interpreted both examinations Observer 1 reviewed DBT first and then CEM, and observer 2 reviewed CEM first and then DBT. Effects of adding CEM to DBT on incremental cancer detection rate (ICDR), cancer type and node status, recall rate, and other performance characteristics of the primary radiologist decisions were assessed. Results Among the participants (mean age at entry, 63.6 years ± 9.6 [SD]), 1273, 819, and 227 women with PHBC completed year 1, 2, and 3 screening, respectively. For observer 1, year 1 cancer yield was 20 of 1273 (15.7 per 1000 screenings) for DBT and 29 of 1273 (22.8 per 1000 screenings; ICDR, 7.1 per 1000 screenings [95% CI 3.2, 13.4]) for DBT plus CEM (P < .001). Year 2 plus 3 cancer yield was four of 1046 (3.8 per 1000 screenings) for DBT and eight of 1046 (7.6 per 1000 screenings; ICDR, 3.8 per 1000 screenings [95% CI 1.0, 7.6]) for DBT plus CEM (P = .001). Year 1 recall rate for observer 1 was 103 of 1273 (8.1%) for (incidence) DBT alone and 187 of 1273 (14.7%) for DBT plus CEM (difference = 84 of 1273, 6.6% [95% CI 5.3, 8.1]; P < .001). Year 2 plus 3 recall rate was 40 of 1046 (3.8%) for DBT and 92 of 1046 (8.8%) for DBT plus CEM (difference = 52 of 1046, 5.0% [95% CI 3.7, 6.3]; P < .001). In 18 breasts with cancer detected only at CEM after integration of both observers, 13 (72%) cancers were invasive (median tumor size, 0.6 cm) and eight of nine (88%) with staging were N0. Among 1883 screenings with adequate reference standard, there were three interval cancers (one at the scar, two in axillae). Conclusion CEM added to DBT increased early breast cancer detection each year in women with PHBC, with an accompanying approximately 5.0%-6.6% recall rate increase. Clinical trial registration no. NCT04085510 © RSNA, 2024 Supplemental material is available for this article.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamografia / Meios de Contraste Limite: Aged / Female / Humans / Middle aged Idioma: En Revista: Radiology Ano de publicação: 2024 Tipo de documento: Article
Texto completo
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamografia / Meios de Contraste Limite: Aged / Female / Humans / Middle aged Idioma: En Revista: Radiology Ano de publicação: 2024 Tipo de documento: Article