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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:

  • For the first 5 years after the diagnosis of
    breast cancer
  • For patients where MRI is recommended but they are unable to have one
  • Elevated risk:
    º There is a genetic mutation
    º Lifetime risk of breast cancer is above 20-25%
    º History of chest radiation before the age of 30
    º Strong family history
  • Recommended after complex mammography
    and/or ultrasound findings

CEM may not be appropriate for people with:

  • Known allergies to iodine or contrast dye
  • Have breast implants. (We can image the
    other breast in cases with one implant)
  • Significant kidney disease
  • Pregnant
Auckland Breast Centre mature lady smiling

What to expect during a Contract-Enhanced Mammogram

  • A mammographer will ask you safety questions and request your consent to go ahead with the examination
  • A small cannula will be placed into a vein, preferably in your elbow crease
  • In the mammography room, you will receive the contrast injection. You may feel a warm sensation or metallic taste in the mouth – this is normal and usually passes off quickly
  • Two minutes after the injection is complete, the mammography exam will start. The images, positions and compression are all the same as a routine mammogram. The mammographers will guide you through the positions
  • You will need to wait for 20 minutes after the injection and then the cannula can be removed
  • A radiologist will review your images and discuss these with you whenever possible before you leave. A detailed medical report will be sent to your GP or surgical team
CEM Brochure Contrast‑Enhanced Mammography (CEM)
PDF 829 KB
FAQs
  • Yes, there’s no need to fast, you can eat as normal before your appointment
  • Please keep hydrated by drinking 2-3 glasses of water 1 hour before your appointment
  • You may 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.