Contrast Enhanced Mammogram (CEM)

What is a Contrast Enhanced Mammogram?

CEM is a 3D mammogram (tomosynthesis) with the addition of contrast dye containing iodine, the same as the dye used in CT.

The dye makes it easier to find new blood vessels that develop when cancers grow.

Your doctor may recommend a contrast enhanced mammogram in the following circumstances:

  • If you are at medium risk of developing breast cancer
  • If you have dense breast tissue which limits the visibility of cancer on a mammogram
  • If you have a breast lump
  • Before breast cancer surgery for women who cannot have MRI
  • Follow up imaging after treatment of breast cancer
  • Personal choice. You may choose to undergo breast imaging assessment in this way, following discussion with your doctor.

Patients are required to fast for two hours prior to the examination. Please continue to drink water and take your normal medication during this period as necessary. Patients who have poor kidney function (renal impairment) or are taking Metformin for diabetes will require a recent blood test, the results of which will help the radiologist to determine if x-ray contrast can be given. It is important to contact us and let us know if you have a known allergy to X-ray/CT Contrast dye prior to the appointment.

The procedure takes approximately 30 minutes.

Upon arrival, you’ll be asked to change into a gown. A small intravenous line is placed in the arm and Iodine dye is injected. After allowing 2 minutes for the dye to flow into the breast, images are acquired like a normal mammogram. Compression needed is the same as for a normal mammogram. It takes 10 minutes to prepare for the dye portion of the test and another 10 minutes to acquire images. It is very important to remain as still as possible, so we can obtain the clearest possible images.

CEM involves slightly more radiation than the normal mammogram. It is the equivalent of having 5 images taken instead of usual 4 with normal mammogram.

Your CEM will undergo processing and a detailed report will be prepared for your referring doctor. This will usually be done within 2 business days. Some CEM findings may need further evaluation with ultrasound/biopsy or sometimes MRI

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