Effectiveness of Contrast-Enhanced Mammography in Breast Cancer Screening: A randomized control Trial

Abstract

Introduction: Early diagnosis depends on breast cancer screening; nevertheless, traditional mammography's sensitivity is generally low, particularly in individuals with thick breast tissue. This paper evaluates Contrast-Enhanced Mammography (CEM) effectiveness relative to conventional mammography in breast cancer detection.
Methodology: Peshawar's Shoukat Khanum Memorial Cancer Hospital and Research Centre performed a randomised controlled trial. Targeted for routine breast cancer screening, random assignment assigned eighty-two women between the ages of forty and seventy in either the CEM or traditional mammography group. The primary findings were sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Among the secondary outcomes were false positives and negative as well as further imaging or biopsy procedures. Statistical comparisons made advantage of T-tests and chi-square tests.
Results: CEM demonstrated a far higher sensitivity 93.3% for conventional mammography than 73.3% (p = 0.046). Although p = 0.31 indicates not statistically significant, specificity was similarly higher in the CEM group (89.3%) than in the control group (78.6%). The CEM group had superior PPV and NPV since false positives and false negatives were lower. Variations in other imaging and biopsy methods had no statistically meaningful effect.
Conclusion: Particularly in people with thick breast tissue, CEM provides more sensitivity than conventional mammography for the diagnosis of breast cancer. CEM seems to lower false positives and wasteful treatments even if specificity, PPV, and NPV differ non-significantly. Confirming these results and evaluating CEM's cost-effectiveness in regular screening call for larger, multi-center investigations.