Customized Position with a Breast Pad for MDCT – A Single-Institution Experience for Breast Cancer Staging

Precise breast cancer (BC) staging, according to TNM classification, is essential for the adequate treatment of every patient. Magnetic Resonance Imaging (MRI) is a preferred method for staging in patients with unclear local status. In some cases, however, a diagnostic and technological difficulties appear when MRI cannot be to performed due to an absolute, anatomical or conditional reason. Methods: We’ve designed and developed an original CT breast pad in two variants with which we’ve successfully scanned and staged 131 women in prone position (modus Spirdonov) with histologically verified BC. The patients were diagnosed and treated at the Breast Unit of University Hospital “Queen Joanna-ISUL”, Medical University of Sofia, Bulgaria for the period October 2016 - March 2021. The women were assessed as ASA I-IV and contraindicated for MRI. Results: In 130 women (99,24%) the results showed a significant discrepancy in the antero-posterior length of breasts resulting in reduction from 2 to 7 times and a mammillar divergence in lateral direction up to 105º when comparing the standard supine scanning with modus Spirdonov. We’ve calculated that in 19.6% of cases the standard protocol was inaccurate in determining the local BC staging. Conclusions: Modus Spirdonov performed on a specially designed CT breast pad in a prone position produced absolutely supreme results in determining BC lesion’s location, size and relation to the surrounding tissues in some patients compared to the standard supine position. We believe that it can be utilized as an adequate replacement when there are limitations or contraindications for performing an MRI.