Breast cancer on contrast mammogram

Case contributed by Dr Sarah Tennant

Presentation

Patient presented with a mass in the left breast

Patient Data

Gender: Female

Low energy images show a moderately dense background pattern, with a mass in the left upper outer quadrant.

Recombined images show an ill-defined mass in the left upper outer quadrant.  No other abnormality in either breast.

Ultrasound confirmed a solid, irregular mass.  Needle core biopsy yielded invasive ductal carcinoma, grade 3.

Case Discussion

Commercially available contrast mammography equipment utilizes the dual-energy technique, also known as contrast-enhanced spectral mammography (CESM).

Two images are produced from each compression: low-energy – equivalent to a standard digital mammogram; and recombined - the background breast tissue is suppressed to highlight areas of contrast uptake.

This case demonstrates its role in the staging of primary breast cancer - increasing confidence in tumor sizing and excluding multifocality.

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