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What is Contrast-Enhanced Mammography?


Contrast‑Enhanced Mammography (CEM) is an advanced breast imaging technique that combines a standard mammogram with an injected contrast dye. The dye provides additional information that can help with earlier detection, especially for women with dense breast tissue or who have had previous breast surgery.

ABC 3d mammography and 3D Tomosynthesis

Why choose Contrast‑Enhanced Mammography (CEM)?

  • Improved cancer detection in dense breasts: CEM overcomes many of the limitations of density by focusing on vascular changes rather than tissue appearance
  • Helps differentiate surgical change from cancerous change: CEM is an excellent addition for screening after breast cancer surgery as it distinguishes post-surgical scars from tumour recurrence
  • Comparable to MRI: It offers a similar cancer detection rate to breast MRI but is quicker, more comfortable, and generally more accessible
  • Fast turnaround: Results are often available the same day

Who is Contrast‑Enhanced Mammography suitable for?

CEM is often recommended for:

  • Further assessment of suspicious findings
  • Follow up after cancer related breast surgery, for the first 5 years
  • As an alternative examination for patients where MRI is unable
  • Determining the extent of a newly diagnosed cancer
  • Monitoring response to chemotherapy
  • Screening women with elevated‑risk factors or dense breasts

CEM may not be appropriate for people with:

  • Known allergies to iodine or contrast dye
  • Have breast implants
  • Significant kidney disease
  • Pregnant
Auckland Breast Centre mature lady smiling

What to expect during a Contract-Enhanced Mammogram

  • Before your mammogram, a small amount of contrast dye is injected into a vein in your arm
  • After 2–3 minutes, once the contrast has circulated, the mammogram is performed
  • The breast compression feels the same as a standard mammogram
  • Two sets of images are taken:

    Low‑energy images:
    comparable to a usual mammogram

    High‑energy images:
    show where the iodine contrast has collected

  • The system then creates a “recombined” image that highlights areas with abnormal blood flow
FAQs

Do not eat for 2 hours prior to your appointment.

Keep hydrated by drinking 2 - 3 glasses of water 1 hour before your appointment is ideal. You may use use the bathroom as normal.

Please do not apply deodorant, body oils, creams or lotions to the breast and under arm area.

Wear clothing that separates at the waist e.g skirt or pants and a top. You will be asked to remove your clothing from the waist up, and you will be given a gown to wear.

Most people tolerate the contrast agent well. Some patients experience a warm sensation, mild metallic taste, or slight flushing, these effects pass quickly. Serious reactions are rare.

CEM is performed in an open room on a standard mammography machine, there are no enclosed spaces.

Coverage is increasing. It may be billed as a diagnostic mammogram, please check with your provider.