Contrast-enhanced mammography in comparison with dynamic contrast-enhanced MRI: which modality is appropriate for whom?

Abstract

Background: Dynamic contrast-enhanced MRI (DCE-MRI) is a revolution regarding screening and diagnosis of breast cancer. Yet, sometimes it is not the appropriate choice of imaging since the examination needs to be scheduled and may take place in another department. Contrast-enhanced mammography (CEM) is contrast-based digital mammogram, and consequently, it has emerged as a potential and promising replacer to DCE-MRI. Main body of the abstract: There is a frequently asked question during the multidisciplinary breast cancer tumor boards is: which modality is more appropriate to be used in each clinical scenario? This article provided a detailed understanding of these two modalities in order to achieve a successful implementation of them into the clinical practice. Which modality to start with, in the context of the detection (screening) followed by characterization or diagnosis of the identified lesions? What is the appropriate application of both modalities in local staging and follow-up? All of these issues would be discussed in this article. Short conclusion: MRI is a safe tool for breast imaging and has a superior diagnostic performance compared to CEM. However, CEM is getting close: this lies in its accessibility, short-time procedure, requirement of less training and feasibility to standardize.