Contrast-enhanced Mammography: Current Applications and Future Directions

Abstract

Contrast-enhanced mammography (CEM) is a developing modality used for the workup and management of breast cancer. Although diagnostic imaging modalities such as mammography and US have historically been the mainstays of initial breast cancer workup, recent advances in breast MRI have allowed better disease evaluation. However, MRI is not always readily available, can be time consuming, and is contraindicated in certain patients. CEM is an alternative to US and MRI, and it can be used to obtain contrast material-enhanced information and standard mammograms simultaneously. A CEM examination is shorter than that of MRI, and the modalities have similar rates of sensitivity to detect lesions. CEM also costs less than MRI. The authors evaluate clinical uses of CEM and discuss the literature supporting these indications. ©

Does contrast-enhanced mammography have an impact on the detection of cancer in patients with risk of developing breast cancer?

“…Contrast-enhanced MRI-combined morphofunctional approach enforces the basis of the vascular-based technique; CEM, which can possibly serve as its alternative [10,12]. CEM images reliably enhanced diagnostic performance when compared with digital mammography, ultrasound, and DBT, with overall performance comparable with CE-MRI [13].…”

A Review of Breast Imaging for Timely Diagnosis of Disease

“…; and the ease of performing second looks at suspicious areas given the patient’s position during the acquisition is more similar to that of conventional imaging than that of prone MRI. On the other hand, limitations of this new technique remain the impossibility of studying breast implants; the greater incidence of adverse reactions to iodinated contrast medium compared to gadolinium; the use of ionizing radiation, which limits the use of CEM in high-risk patients; and the impossibility, at the moment, to perform CEM-guided interventional procedures [ 78 ].…”

Contrast‐enhanced mammography for diagnosing and localizing occult breast lesions

“…CEM has a developing role in breast screening (particularly in high‐density breast tissue), characterization of equivocal mammography findings, tumour staging and monitoring responses to neoadjuvant treatment responses 1,2 . CEM offers an alternative to breast MRI, being highly sensitive (98%) for breast cancer 3,4 .…”