AB027. SOH26AB_0416. Is contrast-enhanced mammography or breast MRI superior in assessing treatment response in patients with breast cancer following neoadjuvant chemotherapy?—an evidence-based approach

Background: Accurate assessment of treatment response following neoadjuvant chemotherapy (NAC) in breast cancer is crucial for guiding surgical planning and further treatment. Magnetic resonance imaging of the breast (MRIB) is currently considered the gold standard for NAC response assessment. Contrast-enhanced mammography (CEM) presents a potential alternative, with shorter acquisition times and increased accessibility. Most recent guidance from the United Kingdom breast cancer group states that “CEM may have similar accuracy” to MRIB, but recognises that evidence to support this claim is limited. The aim of this study is to critically appraise the available evidence in the context of care delivery locally.

Methods: A focused clinical question was formulated using the PICO framework. A comprehensive literature search using keywords and Boolean operators was performed across PubMed, Embase, Scopus, and MEDLINE databases, limited to the past 10 years. Relevant studies were critically appraised using the Critical Appraisal Skills Programme (CASP) checklist, and where applicable, assessed for risk of bias using the QUADAS-2 tool.

Results: One hundred and fifty-seven studies were initially identified. The included studies were assessed as per the methodology. The findings were interpreted within the clinical context with consideration of patient preferences guiding conclusions drawn, in line with an evidence-based medicine approach.

Conclusions: An evidence-based medicine approach supports the potential of CEM as an alternative to MRIB in the assessment of neoadjuvant breast cancer treatment response.

Keywords: Breast cancer; contrast-enhanced mammography (CEM); magnetic resonance imaging; neoadjuvant chemotherapy (NAC); treatment response assessment