Short-term follow-up of contrast-enhanced mammography lesions after negative breast MRI in women with elevated breast cancer risk.

PURPOSE: To determine the outcome of enhancing lesions detected on contrast-enhanced mammography (CEM) that had no correlate on magnetic resonance imaging (MRI) and underwent short-term follow-up CEM. METHODS: In this retrospective single-center study, we identified patients with elevated breast cancer risk who had a CEM between 2014 and 2021 showing indeterminate enhancement on recombined images (BI-RADS 0, 3, 4) that had no correlate on subsequent MRI (performed within one month), and therefore underwent short-term follow-up CEM (performed within eight months). Medical records and imaging studies were reviewed to collect data on patient and lesion characteristics, and outcomes. Cancer incidence with 95% confidence interval (CI) was calculated. RESULTS: This study included 71 women (median age 49 years) with 81 enhancing CEM lesions who underwent short-term follow-up CEM (median 6.2 months) after MRI reported no correlate. Of 81 lesions (median size = 0.7 cm), 73 (90%) were non-mass enhancement and 8 (10%) were enhancing masses. No sonographic correlate was identified for 75 lesions that had a same-day targeted ultrasound. Two cancers (2.5%, 95% CI 0.3-8.6) were diagnosed during the short-term follow-up period, one at 6-months (invasive ductal carcinoma) and one at 12-months (ductal carcinoma in situ). The remaining 79 lesions were benign at 6-month follow-up CEM and at one-year mammographic follow-up. CONCLUSIONS: Follow-up CEM of MRI-occult lesions is prudent and may be reasonable to perform at one-year given the low incidence of cancer detected at six-months (one of 81) in our small study sample.

Diagnosis and Management of Metastatic Breast Cancer in a 33-year-old Pregnant Female: A Case Report.

Despite the rarity, breast cancer diagnosed during pregnancy implies multiple therapeutic dilemmas. The initial diagnostic process can be complicated by the physiological changes that occur in the breast during pregnancy, which can further lead to a delayed diagnosis. Moreover, treatment methods, as well as treatment onset and time of pregnancy termination, remain controversial. This case report highlights some of the inherent difficulties associated with breast cancer diagnosis and treatment in a pregnant patient. It also discusses how to optimize a multidisciplinary approach to improve health outcomes for both the mother and the infant.