CEM May Help Detect Additional Cancers in Women With Extremely Dense Breasts

Background: Extremely increased mammographic density (Breast Imaging Reporting and Data System [BI-RADS] category D) affects about 7.4% of the U.S. female screening population, is an independent risk factor for breast cancer, and is associated with diminished sensitivity of mammography and increased risk for interval cancer. Tomosynthesis is of limited added value in these patients and although adding ultrasound increases cancer detection rates, this substantially increases the false positive rate. Breast MRI does improve cancer detection and reduced interval cancers in these patients but implementation for screening is limited due to cost and availability. Contrast-enhanced mammography (CEM) has recently emerged as a potential alternative to MRI, offering greater availability for vascular imaging with similar performance in breast cancer detection but at a reduced cost compared to MRI. CEM combines low-energy (LE) imaging, equivalent to routine digital mammography, for morphologic e more...