What is it?

Contrast-enhanced mammography (CEM) combines a traditional mammogram with an IV injection of a contrast agent. The contrast highlights blood vessels and areas of increased blood flow, making it easier to identify abnormalities that could indicate cancer.

​

How Does it Work?

During a CEM, a small amount of iodinated contrast dye is injected into a vein. The dye circulates through the breast tissue, enhancing areas with abnormal blood flow or leaky vessels, often associated with malignancies. The mammogram captures these enhanced areas, providing a clearer view of potential concerns.

​

Best for:

CEM is especially valuable for:

• Women with dense breast tissue, where traditional mammograms may miss abnormalities.

• Patients who’ve had inconclusive results from prior imaging.

• Women at higher risk of breast cancer who need a supplemental screening option.

CEM may serve as a cost-effective and more accessible alternative to breast MRI, especially in resource-limited settings.

 

Clinical Performance:

BRAID Study Results: CEM detected three times as many invasive cancers as automated breast ultrasound (ABUS), with the cancers being significantly smaller. (1)

​

Limitations:

Limited availability: CEM is not yet widely accessible.

• Requires contrast dye: As with any contrast-based imaging, there’s a risk of adverse reactions, though rare.

• Emerging evidence: Long-term data and screening guidelines are still evolving for routine use.

• Same field of view limitations as standard mammograms.

 

Regulatory Status:

• While approved for diagnostic purposes, guidelines for routine use in screening are still under review.

• Providers should consider patient-specific factors, including risk level and breast density, when recommending CEM.​