We are evaluating the use of a diagnostic tool that gives more detailed mammography images for some women who are called back for further assessment after breast screening. Contrast-enhanced mammography (CEM) uses contrast dye to identify areas of concern in the breast and can improve cancer detection.
We recall women for a breast assessment when an abnormality is found following a BreastCheck mammogram.
About 1 in 20 women who take part in BreastCheck will be recalled for assessment. Most of these women will not need treatment.
We do further tests at our assessment clinics. This may include another mammogram, an ultrasound, and a biopsy.
Contrast-enhanced mammography
Breast MRI is commonly used alongside mammograms to diagnose breast cancer and plan treatment.
Contrast-enhanced mammography (CEM) can do a similar job and perform just as well in many cases.
CEM is a breast cancer diagnostic tool. It uses a standard mammography machine that has been enabled with new software to capture contrast-enhanced images.
Using this technology, certain types of breast cancer may be easier to see compared to standard mammography. This technology can also be useful in women with dense breast tissue.
CEM is used to help diagnose breast cancer and guide treatment.
It can:
- show how extensive the disease is within the breast
- help clarify unclear findings on a mammogram
- support patients who cannot have an MRI
- monitor how well treatment is working.
We are conducting an evaluation of this diagnostic imaging tool at one of our BreastCheck assessment clinics. We are evaluating its use for women who have specific abnormalities identified on their screening mammogram and are recalled for assessment. CEM is helping us to define the extent of the abnormality at the first visit and helping to limit the number of repeat visits to the unit.
How it works
A contrast enhanced mammogram is similar to a regular mammogram but with one extra step.
Immediately before the mammogram is obtained at the assessment clinic, a woman will get an injection of iodine-based dye into a vein in the arm. Two x-ray images are then taken of each breast. The procedure is performed by a radiographer, under supervision of a radiologist on site.
The contrast dye highlights areas in the breast with unusual or abnormal blood flow, which can be a sign of cancer. This can help radiologists to see cancers more clearly than with a standard mammogram and to better assess the extent of disease in the breast. It is sometimes used to reassure the radiologist that an area of concern in the breast is in fact normal or benign.
Potential benefits for women
CEM is quicker, more comfortable and less expensive than MRI.
- Faster access to care: CEM is quicker, so it could reduce the time between cancer detection and treatment, helping women to get results quicker, start treatment sooner, and reduce stress and anxiety.
- A more comfortable experience: CEM may be more suitable for women who feel anxious or claustrophobic in MRI scanners; or have implanted medical devices or medical conditions that prevent MRI.
- Fewer appointments: CEM can be done on the day of assessment in the BreastCheck clinic avoiding the need for multiple visits as is the case with the use of MRI.
MRI is still the better option in some cases, such as the location of certain cancers or for women with breast implants.
Next steps
The outcome of this evaluation will help determine any further plans for using CEM technology in our BreastCheck assessment clinics.
This includes:
- analysis of its clinical effectiveness
- the cost-benefit of using CEM as a diagnostic tool.
- BreastCheck is for women aged 50 to 69 who do not have symptoms of breast cancer.
- Breast screening aims to find breast cancer at an early stage when it’s easier to treat.
- At BreastCheck, we offer a complete onward service to women who need it. This includes diagnosis, treatment and surgery.