Abstract

Background: Breast cancer remains the second leading cause of cancer-related mortality in adults, predominantly affecting women. Accurate detection of multifocal and multicentric breast lesions is critical for treatment planning, yet limited evidence exists on the diagnostic performance of imaging modalities for these conditions. This systematic review evaluates the sensitivity and specificity of mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in diagnosing multifocal and multicentric breast cancer. Methods: Following PRISMA guidelines, a systematic review was conducted using PubMed, Elsevier, Wiley, and Scientific Information Database (SID) to identify English-language studies published through 2022. Two independent reviewers screened articles, extracted data, and assessed study quality using standardized observational study appraisal tools. Results: Five studies involving 496 patients (mean age: 57.3 years) were analyzed. Pooled sensitivity and specificity for MG/CESM were 89% (95% CI: 84–93%) and 85% (95% CI: 80–89%), respectively. MRI demonstrated comparable sensitivity (85%, 95% CI: 79–90%) but lower specificity (81%, 95% CI: 76–85%). Conclusion: MRI exhibits high sensitivity for detecting multifocal and multicentric breast cancer; however, its specificity lags behind MG/CESM. Integrating complementary imaging modalities may optimize diagnostic accuracy. Further large-scale studies are warranted to validate these findings and refine clinical protocols.