Mamografia com contraste para Triagem do Câncer de Mama: Revisão Sistemática e Meta-Análise

Resumo original em inglês

O que aconteceu

To evaluate pathway-specific cancer detection and summarise screening outcomes (recall/biopsy/PPV3) for contrast-enhanced mammography when reported, and to compare them with those for low-energy mammography and breast MRI.

This systematic review and meta-analysis followed PRISMA guidelines. PubMed (MEDLINE), Embase, Scopus, and Web of Science were searched from January 1, 2011, through August 31, 2025, for studies evaluating contrast-enhanced mammography in screening or surveillance populations (including supplemental/add-on screening and surveillance of patients with a personal history of breast cancer). Diagnostic, recall, and problem-solving studies were excluded. Screening pathways were categorized as: (1) direct comparison with low-energy mammography, (2) direct comparison with MRI, and (3) add-on CEM to mammography-based screening. Random-effects meta-analyses were performed when designs were comparable. Comparisons between CEM and MRI were summarized qualitatively because of heterogeneity and limited cancer events across studies. Single-arm screening studies were summarized descriptively. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2).

O que encontraram

Fourteen studies met eligibility criteria for qualitative synthesis; seven screening and surveillance studies contributed to the meta-analysis. Compared with low-energy mammography, CEM detected 9.3 additional cancers per 1,000 women screened (risk difference [RD], +9.3 per 1,000; 95% CI, 4.0-14.6; P < 0.01; I2 = 0%). Three studies directly compared CEM with MRI in screening settings and were summarized qualitatively because of heterogeneity and limited cancer events.

Por que isso importa

In screening and surveillance populations, contrast-enhanced mammography increases cancer detection compared with low-energy mammography. Evidence from available comparative studies suggests that cancer detection with CEM may be broadly comparable to MRI in selected screening contexts; however, the limited number of studies and heterogeneous designs preclude definitive comparative conclusions. These pathway-specific estimates may inform clinical implementation and the design of prospective screening trials.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.