Contrast Enhanced Digital Mammography:: Basic Principles and Interpretation of Clinical Cases

Breast cancer is the most common cancer in women worldwide. It is of great clinical value to find an accurate and cost-effective way to detect and diagnose early breast cancers in women. While mammography remains the standard for breast cancer screening, image sensitivity and specificity can be affected by several factors. Specifically, in dense breasts sensitivity has been reported to be as low as 30-48%. In the last years, new methods have been developed using contrast media for detection of angiogenesis by tracking contrast agent uptake and washout in suspicious lesions. Contrast enhanced digital mammography (CESM) is one of them. CEDM provides information about the degree of vascularization of the lesion in addition to the morphological information provided by conventional mammography. According to recent studies CEDM is superior to conventional mammography in breast cancer detection and seems to decrease false negatives especially for women with dense breasts. A large clinical study by Dromain et al. showed that digital mammography plus CEDM had higher sensitivity.