Contrast-enhanced mammography in breast cancer screening Review
| Authors: | Coffey, K.; Jochelson, M. S. |
| Review Title: | Contrast-enhanced mammography in breast cancer screening |
| Abstract: | Contrast-enhanced mammography (CEM) is a promising vascular-based breast imaging technique with high diagnostic performance in detecting breast cancer. Dual-energy acquisition using low and high energy x-ray spectra following intravenous iodinated contrast injection provides both anatomic and functional information in the same examination. The low-energy images are equivalent to standard digital mammography and the post-processed recombined images depict enhancement analogous to contrast-enhanced breast magnetic resonance imaging (MRI). Thus, CEM has the potential to detect abnormal morphologic features as well as neovascularity associated with breast cancer. Since its emergence in 2011, CEM has consistently demonstrated superior performance compared with standard mammography and mammography plus ultrasound, particularly in women with dense breasts, with high sensitivity approaching that of MRI, supporting its use as a cost-effective diagnostic and screening tool. CEM has been primarily used in the diagnostic setting to evaluate patients with screening abnormalities or with symptomatic breasts, to perform preoperative staging of newly diagnosed breast cancer, and to evaluate response to neoadjuvant chemotherapy. More recently, CEM has been performed to screen women who have an intermediate to high lifetime risk of developing breast cancer. In addition to its high diagnostic performance, CEM is less expensive and more accessible than MRI and potentially better tolerated by patients. Minor drawbacks to CEM include a slightly increased radiation dose compared with standard mammography and a low risk for contrast allergy reaction. The aim of this study is to review the background, current literature, and future applications of CEM in breast cancer screening. © 2022 Elsevier B.V. |
| Keywords: | treatment response; review; cancer risk; radiation dose; cancer staging; magnetic resonance imaging; antineoplastic agent; cancer diagnosis; preoperative evaluation; sensitivity and specificity; sensitivity analysis; breast cancer; echomammography; cancer screening; breast neoplasms; ultrasound; cost effectiveness analysis; mammography; image enhancement; screening; clinical evaluation; intermethod comparison; neoadjuvant chemotherapy; image processing; iodinated contrast medium; cancer morphology; performance; breast magnetic resonance imaging; diagnostic test accuracy study; digital mammography; human; contrast-enhanced mammography; contrast enhanced mammography |
| Journal Title: | European Journal of Radiology |
| Volume: | 156 |
| ISSN: | 0720-048X |
| Publisher: | Elsevier B.V |
| Date Published: | 2022-11-01 |
| Start Page: | 110513 |
| Language: | English |
| DOI: | 10.1016/j.ejrad.2022.110513 |
| PUBMED: | 36108478 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- Export Date: 3 October 2022 -- Source: Scopus |
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