Single-center prospective study of supplemental screening with contrast-enhanced mammography in women with elevated breast cancer risk

Contrast-enhanced mammography (CEM) and magnetic resonance imaging (MRI) have shown similar diagnostic performance in detection of breast cancer (BC). Limited CEM data are available for high-risk breast cancer screening. A prospective CEM study at Mayo Clinic in Arizona included women aged 35 years with elevated BC risk who had a negative conventional two-dimensional digital breast tomosynthesis screening mammography. The study found a supplemental cancer detection rate with CEM screening of 23.9 per 1,000. CEM screening offered high specificity (0.875; 95% CI 0.844-0.906), high negative predictive value (0.998; 0.993-1.000), and high sensitivity (0.917; 0.760-1.000). During least 1 year of imaging follow-up of all women, one interval cancer was detected on breast MRI 4 months after negative CEM screening. The authors conclude that larger, multi-institutional CEM trials in patients at elevated risk are warranted.