Radiologic model for evaluating the use of contrast mammography in the management of suspicious breast findings

Breast cancer (BC) is the most common malignancy in women. Magnetic resonance imaging (MRI) of the breast is the most sensitive diagnostic method for detecting BC. However, the combination of high cost, unavailability, and contraindications limit the use of MRI for all clinical indications. A few years ago, contrast-enhanced mammography (CEM) was introduced into clinical practice in the Republic of Croatia, which, as an alternative to breast MRI, also allows visualization of tumor neovascularization and provides additional morphological and functional information. Guidelines for radiological diagnosis of breast disease recommend CEM as an adjunct to unclear or suspicious findings after conventional digital mammography.

INNOVATION: CEM is an extremely valuable diagnostic method for detecting suspicious lesions in the breast that can replace breast MRI when it is unavailable or contraindicated. While the absence of imbibition can prevent unnecessary biopsies (69% of cases), suspicious mammographic lesions with imbibition on CEM require further histologic analysis. The outstanding sensitivity and NPV of CEM are very valuable for detecting BC while avoiding unnecessary biopsies.