Role of Contrast Enhanced Mammography in Evaluating BIRADS III and IV 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. Various techniques are being developed to minimize the risk of overlooking lesions in women with dense breasts. CEDM is a new technique, offers the possibility of imaging both breasts in two views (CC and MLO) during a single injection of contrast. It 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. Between the two techniques of CEDM currently being investigated (the temporal subtraction technique and the dual-energy technique), the dual-energy technique offers the possibility