Contrast-enhanced mammography
What is Contrast-Enhanced Mammography?
Contrast-enhanced mammography (CEM), also known as spectral mammography with enhancement, is an advanced breast imaging technique that combines digital mammography with the intravenous administration of an iodinated contrast agent and advanced digital processing. Its purpose is to analyze breast vascularity and highlight abnormal areas or masses of tissue that may take up more contrast, which is a sign of tumor activity.
What is this diagnostic test used for?
The main uses of contrast-enhanced mammography are:
- Breast cancer detection: In breasts with high density of glandular and fibrous tissue, cancer can be more difficult to detect on a regular mammogram. CEM increases the visibility of tumors by highlighting their vascularity.
- Characterization of suspicious lesions: When a mammogram or other imaging technique detects a breast abnormality, but the results are inconclusive, CEM can help determine whether it is a benign or malignant lesion.
- Local staging of breast cancer: After a cancer diagnosis, CEM helps determine if there are other lesions in that breast or in the contralateral breast, which allows for a better definition of the extent of the disease.
- Monitoring response to oncological treatments: It allows monitoring the effectiveness of chemotherapy before surgery, evaluating whether the tumor is responding to treatment.
- Follow-up of patients with personal and family history of breast cancer: In high-risk patients, CEM can be a valuable tool for early detection, complementing other tests.
- Alternative to breast magnetic resonance imaging (MRI): For patients who cannot undergo an MRI or find it difficult to tolerate, CEM is an alternative.
Benefits of high technology in CEM
Contrast-enhanced mammography offers a series of key benefits thanks to the technology it uses:
- Improved detection in dense breasts: Facilitates early cancer detection in dense breasts, where conventional mammograms may be less effective.
- Greater diagnostic accuracy: Allows for more accurate differentiation between benign and malignant lesions, reducing the need for unnecessary biopsies.
- Functional information: Provides information on the vascularity of lesions, which helps determine their activity and aggressiveness.
- Treatment planning: Facilitates more precise cancer staging, helping to plan the most appropriate treatment for each patient.
- Monitoring treatment response: Allows evaluation of whether the tumor is responding to treatment and enables more informed decisions.
How is the procedure?
Contrast-enhanced mammography is a quick and well-tolerated test similar to a conventional mammogram, but with some important differences:
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Preparation:
It is essential to inform your doctor if you have an allergy to iodine or radiological contrast media, suffer from kidney disease, have thyroid problems, are pregnant, or are breastfeeding. Furthermore, before the test, you should remove all metallic objects (jewelry, piercings, etc.) and avoid using deodorants, creams, or talcs in the breast and armpit areas. For this type of test, fasting is not necessary.
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During the test:
A nurse will insert an IV into your arm for the administration of the iodinated contrast. You will be positioned standing in front of the mammography machine, and your breast will be briefly compressed between two plates. Then, several images of each breast will be taken, first without contrast and then with contrast. The complete scan usually lasts only about 10 minutes. It is important to note that it is normal to feel warmth or a strange sensation when the contrast is injected, so do not worry.
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After the test:
It is advisable to drink plenty of water to help eliminate the contrast from your body. You can resume your usual activities immediately after the test. However, if you experience itching, rash, swelling, or difficulty breathing, see a doctor to rule out a possible allergic reaction.
Recommendations for the test
Remember that it is important to follow these recommendations to ensure the quality of the study and your comfort:
- Inform about allergies: It is crucial to inform medical staff if you have a known allergy to iodine or any other contrast medium.
- Inform about pregnancy or breastfeeding: If you are pregnant or breastfeeding, you must inform your doctor before the test, as the contrast medium may not be suitable in these situations.
- Inform about kidney problems: If you have known kidney problems, it is important to communicate this, because the contrast medium is eliminated through the kidneys.
- Avoid using deodorants, talcs, or lotions: Do not use these products in the chest and armpit area on the day of the test, as they can interfere with the images.
- Communicate any medication you are taking: Especially if you are taking diabetes medications (such as metformin), as they may require adjustments before or after the test.
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Are there any risks?
Contrast-enhanced mammography is generally safe, but like any medical procedure involving the administration of a contrast medium, there are some potential risks:
- Allergic reactions to the contrast medium: Although uncommon, allergic reactions can occur, ranging from mild (itching, skin rash) to severe (difficulty breathing, anaphylactic shock). Medical staff are prepared to handle these situations.
- Contrast-induced nephropathy (CIN): In patients with compromised kidney function, the contrast medium can damage the kidneys. Special precautions will be taken if you have a history of kidney problems.
- Radiation exposure: Although the radiation dose in a mammogram is low, there is a minimal risk associated with radiation exposure. The benefits of early breast cancer detection generally outweigh this risk.
- Pain or discomfort at the injection site: Some people may experience pain, bruising, or swelling at the site where the contrast medium is injected.
For your test to proceed smoothly, we ask that you arrive in advance of your scheduled time. This will allow us to complete the necessary administrative and clinical preparation.
Before the test, we will provide you with the Informed Consent form, a document with important information that you must read and sign.
If your appointment is for a Magnetic Resonance Imaging (MRI), it is crucial that you inform us about the presence of pacemakers, metallic objects, prostheses (including dental ones), tattoos, or medication infusion devices, such as insulin pumps.
