Contrast-enhanced mammography: Technical considerations

Contrast-enhanced mammography, a new technique derived from full-field digital mammography, allows the detection of breast tissue changes and tumour vascularity related to neoangiogenesis. Recently, contrast-enhanced mammography has become more widespread in clinical practice, with similar performances than breast MRI, becoming a valuable tool in the diagnosis and staging of primary breast cancer. Contrast-enhanced mammography is more cost-effective and more time-efficient than breast MRI. Contrast-enhanced mammography can be performed after upgrading mammography equipment. Radiation dose is slightly increased, with low risk of iodine contrast medium reaction. French national guidance (Haute Autorité de santé) suggests the use of contrast-enhanced mammography in the initial work up of breast cancer in specific situations. This paper exposes physical and technical considerations of contrast-enhanced mammography, in addition to radiation dose consideration.