New Research Highlights the Long-Term Value of CEM for Women at Increased Risk of Breast Cancer
Contrast-Enhanced Mammography Is Emerging as a Potential Tool for Breast Cancer Screening
As breast imaging continues to evolve, Contrast-Enhanced Mammography (CEM) is gaining increasing recognition as an effective tool not only for diagnostic imaging but also for breast cancer screening, particularly among women at increased risk of developing the disease.
CEM combines conventional mammographic imaging with the administration of an intravenous contrast agent, allowing radiologists to visualize both anatomical structures and areas of increased vascular activity associated with cancer. By integrating morphological and functional information within a single examination, CEM offers enhanced lesion detection capabilities compared with conventional mammography.
Researchers sought to compare the performance of CEM in prevalence and incidence screening rounds. A prevalence screening round refers to examinations performed in patients who have not undergone CEM or breast MRI within the previous three years. Incidence screening rounds, on the other hand, include follow-up examinations performed after an initial screening in patients who have already undergone one of these imaging modalities during the prior interval. This distinction is particularly important because the first screening round tends to detect not only newly developed cancers but also previously existing cancers that had remained undiagnosed, effectively representing a reservoir of previously undetected cancers. Once these cases are identified, cancer detection rates during subsequent screening rounds may decrease. Therefore, the ability to maintain high diagnostic performance over time is a key indicator of the long-term clinical value of a screening technology.
The study analyzed approximately 6,900 CEM screening examinations performed in 2,700 women between 2015 and 2021. Most participants were considered at intermediate risk for breast cancer, with a lifetime risk ranging between 15% and 20%, while some high-risk women chose CEM as an alternative to breast MRI due to contraindications or personal preferences. Researchers compared CEM performance during both the initial screening round and subsequent follow-up examinations.
The results demonstrated a cancer detection rate of 19 cancers per 1,000 examinations during the initial screening round and 11.6 cancers per 1,000 examinations during subsequent rounds. Although the detection rate was lower in follow-up screenings, the difference was not statistically significant. Most importantly, the study showed that CEM sensitivity remained stable over time, confirming its reliability as a continuous screening tool.
The findings also suggest that CEM may provide greater specificity during follow-up screening rounds, helping reduce unnecessary recalls without compromising the detection of clinically significant cancers. This balance between sensitivity and specificity is essential for screening programs aiming to maximize early cancer detection while minimizing patient anxiety, unnecessary diagnostic workups, and invasive procedures.
Scientific evidence continues to strengthen the role of contrast-enhanced mammography in modern breast imaging and screening pathways. CEM represents a more accessible and sustainable contrast-enhanced imaging option for many healthcare facilities and patients.
For breast imaging centers and radiology departments worldwide, these results represent another step toward adoptingadvanced screening technologies capable of supporting earlier and more accurate breast cancer diagnosis. As screening strategies become increasingly personalized, tools like CEM may play a particularly important role for women with dense breasts, an intermediate-risk profile, or limited access to breast MRI.