الفهرس 
? Gross and Microscopic Anatomy of the BreastOnly 14 pages are availabe for public view
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Abstract
Background:
Breast cancer is the most common malignancy in females around the world representing 25.1% of all cancers.
The high prevalence and need for early treatment of breast malignancy highlights the importance of early and accurate diagnosis. In order to achieve this target, it is necessary to select the most appropriate modality for investigation.
Early detection of breast cancer by conventional mammography tends to reduce mortality; however, it has a low sensitivity and specificity in young females with dense breasts owing to reduced contrast between a possible tumor and the surrounding breast tissue with superimposition of glandular tissue obscuring underlying lesions.
Our study included 25 patients with dense breasts presented with different breast symptoms yet breast lump was the most common complaint. The aim of our study is to evaluate the supplementary value of contrast enhanced spectral mammography in assessment of symptomatic patients with dense breast.
Results:
In our study, the enrolled subjects underwent both contrast enhanced spectral mammography (CESM) and conventional full field digital mammography (FFDM). CESM was shown to be better than FFDM in terms of sensitivity, positive predictive value, negative predictive value and accuracy; measuring 100%, 77.8%, 100%, and 84%, compared to 56%, 75%, 46% and 60% respectively, yet both modalities showed low specificity, measuring 63.6% and 66.6% for CESM and FFDM respectively.
Added value of CESM was assessed in terms of ability to detect and correctly characterize the lesions in correlation to histopathological results where CESM could detect 88% of the lesions included in our study and correctly characterized 84% of the lesions, on the other side FFDM detected only 20% of the lesions and correctly characterized 60% of the lesions. CESM changed the treatment plan to a more extensive surgery +/- neoadjuvant chemotherapy in 57% out of fourteen cases diagnosed with breast cancer emphasizing the role of CESM in assessing the extent of the disease, multicentricity and mulltifocality and consequently determining tailoring the most appropriate treatment plan suitable for each patient.
Conclusion:
Contrast enhanced spectral mammography is superior to full field digital mammography in patients with dense breasts with a significant supplementary value in detection, characterization of lesions and tailoring the appropriate treatment plan.