Mamografía contrastada para la detección del cáncer de mama: una revisión sistemática
Date
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
La mamografía con contraste ha emergido como una herramienta complementaria y eficaz en la evaluación diagnóstica del cáncer de mama, especialmente en mujeres con tejido mamario denso. Numerosos estudios han demostrado que ofrece una sensibilidad comparable a la resonancia magnética para la detección de cáncer de mama, con ventajas adicionales como menor costo, mayor accesibilidad, menor tiempo de adquisición y menor tasa de falsos positivos. También ha mostrado utilidad en la caracterización de microcalcificaciones, evaluación de lesiones palpables, respuesta al tratamiento neoadyuvante, y como técnica de detección secundaria en casos indeterminados o de alto riesgo. A pesar de implicar una dosis de radiación ligeramente mayor que la mamografía digital convencional y el riesgo inherente al uso de contraste yodado, los eventos adversos graves son poco frecuentes. Su implementación es factible en la mayoría de los centros que ya cuentan con equipos de mamografía actualizados, lo cual la convierte en una opción rentable para el diagnóstico y tamizaje en poblaciones seleccionadas.
Contrast-Enhanced Spectral Mammography (CESM) has emerged as a promising adjunct imaging modality for breast cancer detection and characterization, particularly in women with dense breast tissue. Multiple studies have shown that offers diagnostic sensitivity comparable to breast magnetic resonance image (MRI), with additional advantages including lower cost, shorter acquisition and interpretation time, improved accessibility, and reduced false-positive rates. CESM demonstrates value in evaluating microcalcifications, palpable abnormalities, neoadjuvant therapy response, and inconclusive findings on conventional imaging. While CESM involves a slightly higher radiation dose than full-field digital mammography and carries risks related to iodinated contrast administration, serious adverse events remain rare. Its integration into clinical practice is feasible for facilities with modern mammography systems, requiring only software upgrades and minimal additional equipment. CESM represents a cost-effective alternative or complement to MRI, particularly for women at average to intermediate risk who are ineligible or unable to undergo MRI screening. Further large-scale studies are warranted to define its role in personalized breast cancer screening strategies.
Contrast-Enhanced Spectral Mammography (CESM) has emerged as a promising adjunct imaging modality for breast cancer detection and characterization, particularly in women with dense breast tissue. Multiple studies have shown that offers diagnostic sensitivity comparable to breast magnetic resonance image (MRI), with additional advantages including lower cost, shorter acquisition and interpretation time, improved accessibility, and reduced false-positive rates. CESM demonstrates value in evaluating microcalcifications, palpable abnormalities, neoadjuvant therapy response, and inconclusive findings on conventional imaging. While CESM involves a slightly higher radiation dose than full-field digital mammography and carries risks related to iodinated contrast administration, serious adverse events remain rare. Its integration into clinical practice is feasible for facilities with modern mammography systems, requiring only software upgrades and minimal additional equipment. CESM represents a cost-effective alternative or complement to MRI, particularly for women at average to intermediate risk who are ineligible or unable to undergo MRI screening. Further large-scale studies are warranted to define its role in personalized breast cancer screening strategies.
Description
Keywords
mamografía con contraste, cáncer de mama, mamografía digital, microcalcificaciones, diagnóstico, tamizaje