Impact of Contrast-Enhanced Mammography on Personalized Surgical Decision-Making in Ductal Carcinoma In Situ: A Multicentre Pilot Observational Cohort Study
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Background: Accurate delineation of ductal carcinoma in situ (DCIS) remains a key challenge in surgical planning. Although contrast-enhanced mammography (CEM) improves lesion detection, its clinical role in informing individualized surgical strategies remains unclear. This study evaluated the impact of CEM on preoperative assessment and surgical planning, with particular emphasis on whether its effect varies across patient subgroups. Methods: This multicentre pilot observational cohort study included 102 patients: 51 prospective patients undergoing preoperative CEM and mammography (MMG) and 51 retrospective controls assessed with MMG alone. Imaging-derived lesion size and planned resection volume were compared with pathological size using correlation analysis, intraclass correlation coefficient (ICC), and Bland–Altman methods. Surgical outcomes were assessed, and subgroup analyses explored differences according to CEM enhancement status. Results: CEM showed improved correlation with pathological DCIS size compared with MMG (ρ = 0.54 vs. 0.37), with the strongest agreement in CEM-positive lesions (ρ = 0.67; ICC 0.745). However, its clinical impact was not uniform. At the population level, CEM did not significantly change planned resection volume or surgical thresholds. In contrast, in CEM-positive patients, CEM was associated with larger planned resections, proportional to pathological tumor burden. Reoperation rates were lower in the CEM cohort (5.9% vs. 17.6%), without statistical significance, and margin status was comparable. Conclusions: The impact of CEM on surgical planning in DCIS is heterogeneous and largely confined to patients with enhancing lesions. These findings suggest that the value of CEM may lie in its selective use, where it can refine assessment of disease extent in specific subgroups rather than in routine application. Further studies incorporating predictive approaches are needed to support risk-adapted imaging strategies.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Impact of Contrast-Enhanced Mammography on Personalized Surgical Decision-Making in Ductal Carcinoma In Situ: A Multicentre Pilot Observational Cohort Study
- Date Crossref
- 17/07/2026
- Éditeur
- MDPI AG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University Hospital Centre Zagreb Department of Diagnostic and Interventional Radiology pays non établi dans la noticeÉtablissement de santé
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University of Rijeka pays non établi dans la noticeUniversité ou école supérieure
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University of Zagreb pays non établi dans la noticeUniversité ou école supérieure
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as2con (Croatia) pays non établi dans la noticeEntreprise
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Clinical Hospital Centre Rijeka Department of Diagnostic and Interventional Radiology pays non établi dans la noticeÉtablissement de santé
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Faculty of Medicine Department of Radiology pays non établi dans la noticeUniversité ou école supérieure
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School of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Community Health Centre Primorsko-Goranska County pays non établi dans la noticeÉtablissement de santé
Department of Diagnostic and Interventional Radiology — University Hospital Centre Zagreb, University of Rijeka et University of Zagreb, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.