Contrast Enhanced Mammogram

Contrast-enhanced mammography (CEM) provides clinicians with more detailed breast cancer detection information, while patients can benefit from increased cancer detection rates and the potential to avoid MRI. For clinicians, CEM acts like a traditional mammogram but with an iodine-based contrast dye injection to highlight abnormal blood vessels associated with cancer, offering higher accuracy than standard mammography in certain cases. Patients experience a short procedure similar to a standard mammogram, though it requires an IV for the contrast agent and can be preferable for those with claustrophobia or metal implants, as it is an alternative to breast MRI.

Which patients benefit the most from this CEM test ?

Individuals with

Dense breast tissue, where traditional mammograms and Ultrasound may miss abnormalities due to tissue similarity.

Inconclusive or unclear findings on standard mammograms or Ultrasound, and require follow-up imaging.

Newly diagnosed breast cancer—CEM helps assess the extent of cancer and track treatment response.

Clinical presentation like palpable lump, pain, nipple discharge etc.

Elevated lifetime risk of breast cancer, such as those with significant family history or other risk factors.

Inability to undergo MRI—due to claustrophobia, metallic implants, or gadolinium allergy.

Individuals who need monitoring after neoadjuvant chemotherapy, breast cancer surgery or cryoablation.

CEM, as a vascular based imaging may reduce false positives and unnecessary call-backs for additional testing, resulting in less anxiety and more efficient care.

Why should you consider contrast mammography? Listen to Contrast Enhanced Mammography expert, Dr. Cathy Keller, Lead Diagnostic Radiologist and Managing Physician from Lake Medical Imaging, Florida, talk about the benefits of how it can subtract away all the dense tissue to see confidently.

For Clinicians

Enhanced diagnostic information: CEM uses an iodine-based contrast dye to visualize areas of abnormal blood flow, which is indicative of cancer. This can help differentiate between benign and malignant masses.

Improved accuracy: Studies show CEM can have a higher sensitivity and accuracy compared to standard mammography, especially in symptomatic patients or those with dense breasts.

Potential to replace MRI: CEM's cancer detection rate is comparable to MRI, but it is often less expensive and can be performed on equipment that is more widely available, making it a more accessible alternative for many patients.

Demonstrates extent of disease: CEM can better show the extent of disease, similar to MRI.

For Patients

Increased cancer detection: CEM can detect cancers that may not be visible on a standard mammogram.

Similar procedure to standard mammography: The process is similar to a regular mammogram, with the addition of an IV injection of contrast dye beforehand. The total exam time is relatively short, around 10 minutes.

Alternative to MRI: For patients who dislike or cannot undergo MRI due to claustrophobia or metal implants, CEM is a viable option.

Contraindications and risks: Patients with certain conditions, such as kidney problems, hyperthyroidism, or a history of severe allergic reaction, may not be able to undergo the procedure. There is a small risk of allergic reaction to the contrast dye, similar to other iodine-based contrast agents.

Follow-up procedures: If a follow-up is needed, it does not necessarily mean cancer is present. It may indicate the radiologist needs a clearer view and may schedule a diagnostic ultrasound, another mammogram or MRI.

How Should I Prepare for My Exam?

Since Contrast Enhanced Mammogram uses an injection of iodine (just like a CT scan or angiogram), we will check to make sure you are not allergic to iodine and may need you to have a blood test to check your kidney function. Just as with all mammogram exams, it is most comfortable for you to wear a two-piece outfit. Please do not apply deodorant on the day of the exam.