Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

Background : Breast edema in inflammatory breast cancer can cause tremendous skin thickening and breast enlargement that attenuates both the x-ray and ultrasound beams because of the enlarged, dense breast tissue filled with fluid and tumor. Objective : was to evaluate the value of Contrast enhanced digital mammography in assessment of breast lesions Patients &methods : A prospective study conducted on 55 female patients presented with primary breast edema . Mammography followed by contrast mammography was done for all cases . Data were analyzed , Statistical tests were performed to check for sensitivity, specificity, accuracy and predictive values for both modalities. Results : CESM was more sensitive and specific in the detection of lesions and better assessment of the local extent of the disease in cases with edematous breast changes . It was accurate in detection of multifocal/multi-centric disease. In cases of metastatic axillary lymph nodes, while being a good positive test in delineation of masses obscured by condensed parenchymal tissue.The calculated sensitivity of DM & CEDM was 87.5 % , 95.6% , specificity was 55.5%, 72%, The PPV and NPV were 91, 93.6 % and 45% ,77.8 % respectively. Conclusion: CESM is a promising and affordable technique in the assessment of suspicious lesions in mammographically dense breast especially in primary odematous breast cases

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