Contrast-Enhanced Mammography

An alternative to breast MRI for high-risk women

Your risk for breast cancer should be determined in consultation with your doctor to determine your eligibility for additional screening tests.

Austin Breast Imaging now offers contrast-enhanced mammography (CEM), a highly accurate and more patient-friendly screening option for high-risk women and breast cancer survivors. CEM has been shown to shorten the time between diagnosis and treatment for women with breast cancer, as well as lower the overall cost of treatment.

Why is a Contrast-Enhanced Mammogram needed?

The availability and cost of a traditional MRI is a barrier for many women who would benefit but it is not always covered by insurance. What’s more, many women find the examination uncomfortable and may feel anxious or claustrophobic during the 45-60 minutes they must remain still inside the MRI scanner. In addition, breast MRI often requires a separate trip to a different facility. In surveys of patient satisfaction, patients prefer CEM to breast MRI.

At ABI, all your breast diagnostic needs are performed at one location, at the same time.

CEM offers comparable sensitivity to breast MRI in detecting cancer¹ and higher specificity,² as well as fewer false positives.³ The exam time is short (8-10 minutes versus 45-60 for MRI) and costs are similar to a diagnostic mammogram.

CEM is performed with the same iodine-based contrast agent used in traditional computed tomography (CT) scans and it is an ideal alternative to MRI for women who are anxious, claustrophobic, obese or have implanted metal devices. In addition, doctors find the test beneficial because it allows them to directly compare CEM images to your prior mammographic examinations. This can help you avoid the need for further work-up or an unnecessary breast biopsy.

Contrast-Enhanced Mammography: Current Applications and Future Directions; Kimeya F. Ghaderi et al. RadioGraphics Vol 39, No. 7
Contrast-Enhance Mammography: Successful Clinical Experience. Hologic case review. Appl Radiol. December 15, 2015
Stephanie A. Lee-Felker, MD et al. Newly Diagnosed Breast Cancer: Comparison of Contrast-enhanced Spectral Mammography and Breast MR Imaging in the Evaluation of Extent of Disease. Radiology: Volume 285: Number 2—November 2017 Pages:389–400.

Before Your Contrast-Enhanced Mammogram

You may not be eligible to have a CEM if you are allergic to iodine or have kidney failure. If you are taking metformin for diabetes (Glucophage, Riomet, Fortamet, Glumetza or Glucophage XR), you must refrain from taking this medication for several days prior to CEM.

If you are still having menstrual periods, you may schedule a screening mammogram anytime of the month. However, if your breasts are usually tender during your period, you may want to have your mammogram or procedure performed within two weeks after your menstrual period ends.

In addition, please remember:

Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. The residue left on your skin by these substances may interfere with interpretation of the mammogram.
If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam.
For your safety, please notify our scheduling department and technologists if you believe you may be pregnant or if you have breast implants

During Your Contrast-Enhanced Mammogram

Our technologists are dedicated to breast imaging and take special care to make the experience as comfortable as possible. You will need to remove any jewelry that might interfere with the X-ray picture. You will need to remove your clothes above the waist, and you will be given a robe for the test.

You will be given an iodine-based injection prior to your exam. This will help the radiologist in performing the examination. Please be sure to inform us if you have any allergies to iodine or have kidney disease prior to your examination.

One at a time, your breasts will be positioned on a flat plate that will acquire the image while a paddle compresses your breast tissue. Firm compression is needed to spread out the tissue and obtain a high-quality image. You will be instructed to hold your breath during the exam for just a few seconds of compression. You may be asked to lift your arm or use your hand to hold your other breast out of the way. Several pictures are taken of each breast, from the top and from the side.