Figure 6:
Images of response monitoring using contrast-enhanced mammography in a 54-year-old woman diagnosed with 3.0-cm invasive breast cancer of no special type (grade 3, estrogen receptor negative, progesterone receptor negative, and human epidermal growth factor receptor type 2 positive). A, Low-energy image in craniocaudal view shows cancer. B, Recombined image shows peripheral enhancement, which is suggestive of central necrosis. The patient underwent neoadjuvant systemic therapy. C, Low-energy, and, D, recombined craniocaudal views obtained during treatment show decrease in index tumor size (C) with decrease in enhancement (D). E, Low-energy and, F, recombined images obtained after completion of therapy. There was no residual mass on low-energy image. Resolution of enhancement on recombined image was consistent with complete radiologic response. Surgical specimen showed pathologic complete response without any residual ductal carcinoma in situ.