New Trends in Breast Imaging
- Contrast-enhanced mammography (CEM) was introduced in 2011 as a modality able to increase mammography’s diagnostic performance. A CEM examination consists of an intravenous administration of an iodinated contrast agent, followed by a dual-energy mammography of both breasts in two views as minimum (Fig. 1). Different CEM units from different vendors are currently available and the imaging protocol was published earlier . Multiple studies have shown that this approach increases the diagnostic accuracy of mammography significantly [2,3], even matching the performance of breast MRI .
- The aim of any population screening programme is to reduce mortality while minimising harm to the individual and at an acceptable financial cost to the health economy . When specifically discussing breast screening, reducing mortality depends not on overall cancer detection but on identifying small high grade invasive cancers  and high grade DCIS . Tabar  showed that in the Swedish 2 counties study much of mortality reduction was due to grade 3 cancer detection (P < 0.001) and more deaths prevented from grade 3 tumors (n = 95) than grade 1 and 2 tumors combined (n = 48).