Naglaa Abdel Razek MD, Presenter: Nothing to Disclose

Loai Ezat MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to determine whether dynamic CT mammography using 64-slice MDCT could assist in differentiating between fibrotic postoperative scar and cancer recurrence in patients underwent breast conserving surgery.

Between July 2006 and April 2007, 126 consecutive patients with breast cancer treated with conservative surgery and radiotherapy underwent CTM, when a malignant lesion on the site of lumpectomy was suspected by ultrasound and/or mammography. CTM scans were evaluated by morphological and dynamic characteristics. CTM diagnosis was compared with histology results of FNB,CNB & OB. Enhancing areas independent of the prior lumpectomy site, incidentally detected during the CTM, were also evaluated.

MD-CTM findings were compared with histology in 126 patients . CT mammography (CTM) showed 94.28% sensitivity, 98.9% specificity, 97.05% positive predictive value and 97.8% negative predictive value for detection of recurrence on the surgical scar. CT-mammography detected 8 lesions remote from the scar. The overall accuracy of CTM for detection of breast malignancy on top of a scar was 91.6% , compared to overall accuracy of 69 % & 77.7 % by conventional mammography and sono-mammography respectively. Moreover CTM was superior to Conventional Mammography and Sonomammography in diagnosis of lesions fixed to the pectoral muscle & chest wall .

MD-CT mammography is a sensitive method to differentiate recurrence from post-treatment changes at the prior lumpectomy site after conservative surgery and radiation therapy. The high negative predictive value of this technique can avoid unnecessary biopsies or surgical treatments.

CTM can be used to diagnose cancer recurrance ,it can be applied as well to image intraductal spread of breast cancer, involvment of the skin, chest wall &involvment of the axillary lymph nodes.

Abdel Razek, N, Ezat, L, Role of Low Dose State-of-the-Art 64-slice CT Mammography in the Evaluation of Postoperative Breasts.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5007185.html