ECR Mammography Study: Pre-Op CEM Detects 34 Percent More Multifocal Masses than Mammography

New research presented at the European Congress of Radiology (ECR) suggests that preoperative use of contrast-enhanced mammography (CEM) offers a key advantage over mammography with respect to detection of multifocal masses.

For the study, researchers compared preoperative CEM and mammography in 69 patients (average age of 55.8) with breast cancer confirmed via biopsy or cytology.

The study authors found that CEM detected 92.3 percent of multifocal masses in contrast to 58.3 percent for mammography.

Here one can see the use of contrast-enhanced mammography (CEM) to detect breast cancer in a 45-year-old woman. In a recent study presented at the European Congress of Radiology (ECR), researchers found that preoperative use of CEM detected 34 percent multifocal masses than mammography. (Images courtesy of Radiology.)

“(Contrast-enhanced mammography) is a valuable, cost-effective alternative to MRI for assessing tumors before surgery, particularly in preoperative staging and the identification of multifocal lesions,” wrote lead study author Marina Balbino, M.D., who is affiliated with Foggia University in Foggia, Italy, and colleagues.

(Editor’s note: For related content, see “New Mammography Studies Assess Image-Based AI Risk Models and Breast Arterial Calcification Detection,” “Study: Mammography AI Leads to 29 Percent Increase in Breast Cancer Detection” and “How Does Hormonal Regulation Impact Background Parenchymal Enhancement on Contrast-Enhanced Mammography?”)

While preoperative CEM underestimated the size of lesions in 28 cases compared to 21 cases for mammography, the researchers noted no significant difference between CEM and histological measurements. The study authors pointed out that histology findings revealed mass-like neoformations in over 49 percent of the cohort.

“(Contrast-enhanced mammography) showed high diagnostic accuracy in preoperative staging, supporting its use over MRI, particularly due to its lower cost, faster acquisition time, and better patient tolerance,” noted Balbino and colleagues.

Reference

1. Balbino M, Masino F, Montatore M, et al. Diagnostic accuracy of contrast-enhanced mammography (CEM) in preoperative staging of breast tumors: a comparative study with histology and mammography. Presented at European Congress of Radiology (ECR), February 26-March 2, 2025, Vienna, Austria. Available at https://www.myesr.org/congress/ . Accessed February 28, 2025.