CONTRAST-ENHANCED MAMMOGRAPHY (CEM) AS A BREAST IMAGING MODALITY: INITIAL EXPERIENCE AT A TERTIARY CARE CENTER

Abstract

Background & Objective:

CEM is a valuable imaging diagnostic tool for diagnosing and characterizing breast lesions. It offers potential to overcome some of the limitations of conventional mammography. The objective of this study was to report the initial experience of implementation of CEM as a breast imaging modality, its diagnostic utility, imaging features of lesions and cost analysis.

Methods:

Patients who underwent CEM examinations from January 1, 2022, to June 31, 2023, were included. The data included patient demographics, prior imaging, clinical indications, enhancement patterns on CEM, and histological diagnoses. The patients with insufficient electronic health records/ imaging/ histopathology were excluded.  

Results:

The study included 36 patients who underwent CEM with an average age of 47.1 years. The most common clinical indication for performing CEM was preoperative staging, accounting for 30 of the total cases. Background enhancement was predominantly mild in 19 cases. Out of the 30 (83%) malignant cases, 29 showed enhancement of the lesions on CEM. No enhancement was seen in one case of response evaluation which revealed complete pathological response on post-surgical pathology. The remaining six cases with no enhancing lesion, on ultrasound were reported as BIRADS I and BIRADS II on ultrasonography. On CEM, 26 (87%) of the malignant lesions showed mass-like enhancement and all were infiltrating ductal carcinoma on histopathology.

Conclusion

CEM has shown promise as a low-cost and accurate diagnostic technique for breast cancer diagnosis and local staging. It has the potential to overcome the limitations of traditional mammography and MRI

Key words: contrast enhanced mammography; MRI breast; mammography