Evidence map›Paper›PMID 39049869›Full record

ArticleThe Lancet regional health. Europe2024

Contrast-enhanced mammography versus conventional imaging in women recalled from breast cancer screening (RACER trial): a multicentre, open-label, randomised controlled clinical trial.

Lidewij M F H Neeter, Patricia J Nelemans, H P J Raat, Caroline Frotscher, Katya M Duvivier, Brigitte A B Essers, Marjolein L Smidt, Joachim E Wildberger, Marc B I Lobbes

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Europe, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Review
  3. Contrast-enhanced mammography improves patient access to functional breast imaging.Journal of medical imaging and radiation oncology · 2025
    Review
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Lidewij M F H NeeterMaastricht University Medical Center, Department of Radiology and Nuclear Medicine, P.O. Box 5800, 6202AZ, Maastricht, the Netherlands.
Patricia J NelemansMaastricht University, Department of Epidemiology, P.O. Box 616, 6200MD, Maastricht, the Netherlands.
H P J RaatLaurentius Hospital, Department of Radiology, P.O. Box 920, 6040 AX, Roermond, the Netherlands.
Caroline FrotscherZuyderland Medical Center, Department of Medical Imaging, P.O. Box 5500, 6130 MB, Sittard-Geleen, the Netherlands.
Katya M DuvivierAmsterdam University Medical Center, Department of Radiology, P.O. Box 7057, 1007MB, Amsterdam, the Netherlands.
Brigitte A B EssersMaastricht University Medical Center, Department of Clinical Epidemiology and Medical Technology Assessment, P.O. Box 5800, 6202AZ, Maastricht, the Netherlands.
Marjolein L SmidtGROW School for Oncology and Reproduction, Maastricht University, P.O. Box 616, 6200MD, Maastricht, the Netherlands.
Joachim E WildbergerMaastricht University Medical Center, Department of Radiology and Nuclear Medicine, P.O. Box 5800, 6202AZ, Maastricht, the Netherlands.
Marc B I LobbesMaastricht University Medical Center, Department of Radiology and Nuclear Medicine, P.O. Box 5800, 6202AZ, Maastricht, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Women recalled from breast cancer screening receive post-screening work-up in the hospital with conventional breast imaging. The RACER trial aimed to study whether contrast-enhanced mammography (CEM) as primary imaging instead of conventional imaging resulted in more accurate and efficient diagnostic work-up in recalled women. Methods: In this randomised, controlled trial (registered under NL6413/NTR6589) participants were allocated using deterministic minimisation to CEM or conventional imaging as a primary work-up tool in two general and two academic hospitals. Predefined patients' factors were reason for recall, BI-RADS score, and study centre. Primary outcomes were sensitivity and specificity. Secondary outcomes were the proportion of women needing supplemental examinations, and number of days until diagnosis. Findings: Between April, 2018, and September, 2021, 529 patients recalled from the Dutch screening program were randomised, 265 to conventional imaging and 264 to CEM. Three patients in the control arm had to be excluded from analysis due to a protocol breach. After the entire work-up, sensitivity was 98.0% (95% CI; 92.2-99.7%) in the intervention arm and 97.7% (91.8-99.6%) in the control arm (p = 1.0), and specificity was 75.6% (72.5-76.6%) and 75.4% (72.5-76.4%, p = 1.0), respectively. Based on only primary full-field digital mammography/digital breast tomosynthesis or CEM, final diagnosis was reached in 27.7% (73/264) in the intervention arm and 1.1% (3/262) in the control arm. The frequency of supplemental imaging was significantly higher in the control arm (p < 0.0001). Median time needed to reach final diagnosis was comparable: 1 day (control arm: IQR 0-4; intervention arm: IQR 0-3). Thirteen malignant occult lesions were detected using CEM, versus three using conventional imaging. No serious adverse events occurred. Interpretation: Diagnostic accuracy of CEM in the work-up of recalled women is comparable with conventional imaging. However, work-up with CEM as primary imaging is a more efficient pathway. Funding: ZonMw (grant number 843001801) and GE Healthcare.

Indexed as

Breast neoplasmMammographyScreening

Identifiers

PMID39049869
PMCPMC11268340

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.