Contrast-Enhanced Mammography (CEM)

Research has shown that contrast-enhanced mammography finds breast cancer better than traditional mammograms and similar to breast MRI. This means that CEM finds breast cancers that could be missed on regular mammograms or ultrasound. In some instances, contrast-enhanced mammography can be used as an alternative to breast MRI. CEM is a safe, low-radiation test that feels just like a regular mammogram and patient results are available shortly after the exam.

The main difference is that contrast-enhanced mammography images are taken after an intravenous (IV) line is placed in the arm and contrast material (X-ray dye) is administered through the IV line. After that, the rest of the CEM feels like a regular mammogram. The contrast goes to areas of increased blood flow in the body. Because breast cancers generally have more blood flow, they will often attract the contrast. The contrast makes the cancers much easier to see than on a regular mammogram.

Both routine mammography and contrast-enhanced mammography are safe, low-radiation-dose tests. The radiation dose with CEM is within the range of what you normally receive with a mammogram.

The contrast used in CEM is the same as that used for CT scans and is considered very safe. Potential side effects include a small chance of an allergic reaction and problems with kidney function. Patients at risk for an allergic reaction are generally those with other severe allergies or who have reacted to contrast in the past (for example, with a CAT scan). The most common reaction is hives, but more severe reactions are possible. Those at risk for kidney problems are patients with kidney disease. Before your exam, our Breast Imaging team will ask you questions to ensure that this exam is safe for you.

There are no special preparations for contrast-enhanced mammography. You may eat and drink normally and take routine medications as usual before and after your exam.

To start, our Radiology nurse will confirm you can safely get a CEM. This will include a review of your medical history. If contrast-enhanced mammography is appropriate for you, an IV is then placed in your arm and contrast is administered. You will then have CEM, which will feel the same as your regular mammogram. Many patients report a warm feeling in their pelvis or an urge to urinate after the contrast is administered, both of which quickly subsides. You should expect to be in the Breast Imaging department for approximately the same amount of time as your regular diagnostic mammogram. The main difference will be the time to place the IV line, which will take approximately 10–15 minutes.

After your CEM, you will talk to a radiologist who will discuss the results of your exam during your same appointment that day and also provide you with the opportunity to ask questions.

CEM gets billed to insurance as a bilateral diagnostic mammogram with contrast. A CEM does cost more than a regular screening mammogram but less than a breast MRI. Please consult your insurer to determine the cost of your CEM.

Please call us at 617-754-9500 to schedule a CEM and to ask us any additional questions.