Evidence map›Paper›PMID 40153207›Full record

ArticleLa Radiologia medica2025

Evaluation of contrast-enhanced mammography (CEM) in the preoperative staging of breast cancer: large-scale single center experience, update to 1005 cases.

Giulia Bicchierai, Giuliano Migliaro, Francesca Pugliese, Francesco Amato, Diego De Benedetto, Ermanno Vanzi, Federica Di Naro, Cecilia Boeri, Chiara Bellini, Sofia Vidali and 5 more

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Article in La Radiologia medica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Article
  2. Review
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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

15 authors.

Giulia BicchieraiDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy. giulia.bicchierai@gmail.com.ORCID http://orcid.org/0000-0003-1979-7593
Giuliano MigliaroDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
Francesca PuglieseDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
Francesco AmatoRadiology Department, Ospedale San Giovanni Di Dio, Agrigento, Italy.
Diego De BenedettoDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
Ermanno VanziDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
Federica Di NaroDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
Cecilia BoeriDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
Chiara BelliniDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
Sofia VidaliDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
Kassandra ToncelliDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
Simonetta BianchiDivision of Pathological Anatomy, University of Florence, Florence, Italy.
Lorenzo OrzalesiBreast Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Vittorio MieleEmergency Radiology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Jacopo NoriDiagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study was to assess the diagnostic performance of CEM in the preoperative staging of breast cancer in a large cohort of patients. MATERIALS AND

methodsA retrospective review of preoperative staging CEM exams was conducted at our centre between June 2016 and June 2021. We evaluated cases where CEM influenced the type of surgery, necessitated additional biopsies or imaging, and identified additional lesions. The sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy of CEM for the entire sample and each subgroup setting were calculated. A receiver operating characteristic (ROC) curve and multivariate analysis were performed.

results991 women, mean age 61.3 years old [35-93], with 1005 malignant lesions were included. CEM led to additional imaging in 36.7% (364/991) women and to additional biopsies in 18.5% (183/991) women. CEM altered the initial surgical plan based on conventional imaging in 226 out of 991 patients (22.8%). CEM had a sensitivity in the whole population of 91.5% (204/223), specificity of 96.8% (757/782), PPV of 89.1% (204/229), NPV of 97.5% (757/776) and an accuracy of 95.6% (961/1005); the AUC of the ROC curve was 0.941. We found CEM better performed in patients with a low BPE level compared with a high BPE level (ρ = 0.028861). We see that the presence of additional lesions at CEM was the only significant predictor in the model.

conclusionThis study reaffirms the high diagnostic accuracy of CEM for preoperative breast cancer staging in a large patient cohort.

Indexed as

Breast NeoplasmsContrast MediaMammographyAdultAgedAged, 80 and overFemaleHumansMiddle AgedNeoplasm StagingPredictive Value of TestsPreoperative CareRetrospective StudiesSensitivity and SpecificityContrast MediaBreastBreast neoplasmsContrast mediaDiagnostic techniques and proceduresMammographyNeoplasm staging

Identifiers

PMID40153207

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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.