Contrast-enhanced mammography in comparison with dynamic contrast-enhanced MRI: which modality is appropriate for whom?

Abstract

Background Dynamic contrast-enhanced MRI (DCE-MRI) is a revolution regarding screening and diagnosis of breast cancer. Yet, sometimes it is not the appropriate choice of imaging since the examination needs to be scheduled and may take place in another department. Contrast-enhanced mammography (CEM) is contrast-based digital mammogram, and consequently, it has emerged as a potential and promising replacer to DCE-MRI. Main body of the abstract There is a frequently asked question during the multidisciplinary breast cancer tumor boards is: which modality is more appropriate to be used in each clinical scenario? This article provided a detailed understanding of these two modalities in order to achieve a successful implementation of them into the clinical practice. Which modality to start with, in the context of the detection (screening) followed by characterization or diagnosis of the identified lesions? What is the appropriate application of both modalities in local staging and follow-up? All of these issues would be discussed in this article. Short conclusion MRI is a safe tool for breast imaging and has a superior diagnostic performance compared to CEM. However, CEM is getting close: this lies in its accessibility, short-time procedure, requirement of less training and feasibility to standardize.

Addressing Misinformation About the Canadian Breast Screening Guidelines

“…Contrast-enhanced mammography (CEM) is almost as sensitive as MRI and is much less expensive but has been far less evaluated for screening and is not yet Health Canada approved for screening. [44][45][46] CEM in addition to mammography can increase sensitivity from 71.5% to 92.7% and specificity from 51.8% to 67.9%. 47 Another study showed 13 of 14 cancers (93%) occult on mammography but seen on CEM were in women with dense breasts.…”

Existing and Emerging Breast Cancer Detection Technologies and Its Challenges: A Review

“…3D mammography (or called tomosynthesis) produces X-ray images of the breast by taking various views across the breast in an arc. Previous studies reported that the detection is significantly improved when 3D mammography was used with 2D mammography [42]. A mammography expert, often known as a mammographer, performs this process.…”

Mamografía con contraste: nuestra experiencia

“…El avance en los métodos imagenológicos en los últimos años ha hecho que la elección del más adecuado para la realización de un diagnóstico resulte un desafío 1 .…”

“…En la actualidad hay falta de consenso acerca de sus indicaciones, pudiendo ser similares a las de la resonancia magnética (RM) de mama. Entre ellas se mencionan algunas como detección de cáncer de mama, estadificación preoperatoria, caracterización de hallazgos indeterminados y seguimiento de la respuesta a la terapia neoadyuvante 1,[4][5][6] .…”