Contrast-Enhanced Mammogram (CEM)

What Is a Contrast-Enhanced Mammogram (CEM)?

A contrast-enhanced mammogram (CEM) is performed the same way as a standard mammogram, but you also receive a small amount of contrast dye through an IV. The dye helps highlight areas of breast tissue, so your care team can see more detail, which can make it easier to detect breast cancer earlier. Most people tolerate the contrast well. It is considered an advanced imaging tool for breast cancer detection.

Who May Be a Candidate for CEM?

Your doctor may recommend CEM if you:

• Have an increased risk of breast cancer (personal history, family history, or genetic predisposition)
• Have dense breast tissue, making standard mammograms harder to interpret
• Have inconclusive results from a screening mammogram
• Have a lump or lumps identified during a physical exam
• Have contraindications to breast MRI

CEMs are also helpful for women who have been diagnosed with breast cancer. The contrast dye provides additional viewing access to any areas already identified as cancerous and can help assess the effectiveness of breast cancer treatment already in progress.

What Are the Benefits of a CEM?

• More comprehensive images of dense breast tissue
• CEM may provide more accurate information about dense breast tissue than other forms of mammography. Dense breast tissue can make it difficult to clearly see problem areas with traditional 2D or 3D technology. The use of contrast dye helps display abnormalities that might be hidden otherwise.
• An alternative to breast MRI. Women who are claustrophobic and cannot tolerate MRI testing may be more comfortable with contrast-enhanced mammography. In addition, mammography generally takes less time to perform, and results are available faster than with MRI testing. The cost of mammography is often lower than MRI testing.

3D Screening Mammogram (Tomo) vs.
CEM: What Are the Differences in These Two Exams?

3D screening mammograms and CEMs are both used to identify breast abnormalities and diagnose cancer as early as possible. Both exams compress the breasts and take multiple X-ray images of breast tissue.

There are two main differences between these two tests. First, the CEM may last longer than the 3D mammogram because of the extra time involved in administering the contrast solution. Second, the contrast dye produces images that highlight problem areas more distinctly and may allow your doctor to view the breast tissue better to make a diagnosis.

What Risks Associated with CEM

There is a small risk with using a contrast agent that is injected into a vein during the CEM. The contrast agent is a special dye that highlights organs, blood vessels, or tissue to make them more visible. Depending on the type of contrast agent that is used, it may cause decreased kidney function or worsen kidney function in people who already have kidney disease. 

Occasionally, people can have an allergic reaction (such as hives or itching) to the contrast agent. Serious reactions (for example, a drop in blood pressure or trouble breathing) are rare. 

Is there a Chance of Abnormal Findings on a CEM?

There is a chance of having an abnormal CEM. This could require further testing with mammograms, ultrasound, MRI, or breast biopsy.

Contact ELizabeth Wende Breast Care to learn more.