Can the application of computed tomography laser mammography (CTLM) in dense breast (category 3,4 according to ACR) examinations combined with x-ray mammography enhance the detection of breast cancer?
Background: The aim of this study was an attempt to answer the question whether laser mammography in dense breast (classified as category 3,4 according to ACR) examination together with x-ray mammography can enhance the detection of breast cancer. Material/Method: 248 women who had undergone a CTLM examination and mammography in the Department of Radiology of Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in the years 2005-2007 were analyzed retrospectively. In these examinations, x-ray mammography did not reveal lesions (BIRADS 1, category 3 and 4 according to ACR). An interval between CTLM and mammography did not exceed 30 days. The examination result was verified by cytology/histopathology or observation after a minimum of 12 months provided a regular result. CTLM visualizes normal and pathological blood vessels and tissues which are rich in blood, because laser rays used in CTLM (808nm) are more absorbable by hemoglobin than by the surrounding tissue, making it possible to show a malignant tumor by its accompanying angiogenesis. The result of CTLM mammography was qualified either as the presence (+) or absence (–) of angiogenesis. Results: Among 248 women, angiogenesis was discovered by CTLM in 48 cases, in the CTLM (+) Group 13/48 women were diagnosed with breast cancer, whereas 35/48 were diagnosed with benign lesions. Angiogenesis was not identified in 200 women, in the CTLM (-) group 13/200 were diagnosed finally with cancer, with 187/200 patients having no malignancy. Ultimately, in the group of 248 women (with dense breast, category 3 and 4 according to ACR), in whom x-ray mammography did not reveal malignant processes (BIRADS 1), 26 cancers were detected out of which 13 were revealed with CTLM Conclusions: Computed Tomography Laser Mammography, when used as an adjunct to x-ray mammography, enhances the detection of breast cancer in women with dense breast tissue
