ABS ePoster Library

Introduction:
Quicker and easier to interpret than MRI, CESM is gaining in popularity. As a novel technique, experience is limited and the impact on management is unknown.

Method:
Retrospective study comparing pathology, mammogram and CESM findings for selected patients treated at KGH during 2015/16. CESM is usually recommended for dense breasts or discrepancies in initial assessment. Patients having neoadjuvant chemotherapy were excluded. The surgical management plan before and after CESM was recorded.

Results:
Average age was 52.2 years (n=41). 58.5% presented symptomatically, the remainder through screening. The majority had invasive disease with or without DCIS (93.2%). Of the cancers, 88.6% were ductal, 90.9% grade 2 or 3, 81.8% ER positive, 90.9% HER 2 negative and 63.6% N0.

In 70.5%, lesion size measured at CESM was more accurate than plain MMG.
Unexpected multifocality was seen in 7 patients on CESM and 11 patients underwent additional biopsies as a result.
In total, 20 women underwent breast conserving surgery (BCS), 16 unilateral mastectomy and 3 bilateral mastectomy. Pre- and post-CESM surgical plans differed in 16 patients. In 12, this change was deemed surgically necessary (1 unilateral to bilateral mastectomy, 9 BCS to mastectomy and 2 mastectomy to BCS). The remaining 4 were due to patient choice.

Conclusion:
CESM more accurately sized a lesion than MMG in over 2/3rds of our patients. The surgical plan was altered appropriately in 34.8% as a consequence. In selected patients, CESM can aid surgical planning.