The Role of Contrast Enhanced Mammography in Assessment of Malignant Breast Lesions

Abstract

Breast cancer is one of the most common types of cancer. Despite major advances in mammography, at least 10-20% of breast cancers can go undetected using screening mammography alone. The accuracy of mammography is especially limited in dense breasts where the surrounding fibroglandular tissue decreases the conspicuity of the lesions. Even when lesions are detected the full extent of the disease may not be clearly depicted. Ultrasound is a complementary technique for mammography especially for dense breasts, but US examinations are time consuming and operator dependant. Contrast-enhanced MRI is currently the most sensitive breast cancer detection technique, though it has high false positive rate and still carries the burden of high cost and low availability. Various techniques are being developed to minimize the risk of overlooking lesions in women with dense breasts. CEDM is a new technique, currently under evaluation to determine the best indications for it and to assess its possible diagnostic benefits. CEDM has the advantage of being a fast imaging technique, which can be performed by using a current digital mammography system with some specific software and hardware adaptations and has the advantage of being reproducible without operator dependency.