Using Breast Cancer Surveillance Consortium data, the women most likely to present with interval cancers were women with an elevated 5-year risk for breast cancer >1.67% and with dense breast tissue, representing approximately 24% of all women with dense breasts [64]. Mammography With IV Contrast CEDM combines the techniques of conventional mammography with administration of IV contrast, thus leveraging functional imaging by assessing for lesion vascularity. A dual-energy technique is utilized to acquire the images in the conventional craniocaudal and mediolateral oblique projections. The acquired data are processed, producing a low-energy image and a diagnostic recombined image. There is limited literature regarding the use of CEDM in the screening setting. However, in the diagnostic setting, CEDM has been shown to demonstrate improved sensitivity and specificity over 2-D mammography [28-31]. The greatest improvement in the sensitivity and specificity is seen in women with dense breast tissue [29,30]. At this time, there is limited but emerging literature regarding the use of mammography with IV contrast for supplemental screening in intermediate-risk women with dense breasts. However, in women with dense breast tissue and given the limited sensitivity of mammography and the need for supplemental screening, CEDM may have a potential role; however, more data on CEDM in the screening setting in intermediate-risk women with dense breast tissue are needed. MRI Breast Without IV Contrast Abbreviated There is no relevant literature regarding the use of AB-MRI breast without IV contrast for supplemental screening in intermediate-risk women with dense breasts. MRI Breast Without and With IV Contrast Abbreviated AB-MRI performed with IV contrast is an abbreviated breast MRI examination. It is similar to a full MRI examination yet does not have a standard protocol; however, at minimum, it must include a precontrast and one postcontrast sequence.
Supplemental Breast Cancer Screening Based on Breast Density. Using Breast Cancer Surveillance Consortium data, the women most likely to present with interval cancers were women with an elevated 5-year risk for breast cancer >1.67% and with dense breast tissue, representing approximately 24% of all women with dense breasts [64]. Mammography With IV Contrast CEDM combines the techniques of conventional mammography with administration of IV contrast, thus leveraging functional imaging by assessing for lesion vascularity. A dual-energy technique is utilized to acquire the images in the conventional craniocaudal and mediolateral oblique projections. The acquired data are processed, producing a low-energy image and a diagnostic recombined image. There is limited literature regarding the use of CEDM in the screening setting. However, in the diagnostic setting, CEDM has been shown to demonstrate improved sensitivity and specificity over 2-D mammography [28-31]. The greatest improvement in the sensitivity and specificity is seen in women with dense breast tissue [29,30]. At this time, there is limited but emerging literature regarding the use of mammography with IV contrast for supplemental screening in intermediate-risk women with dense breasts. However, in women with dense breast tissue and given the limited sensitivity of mammography and the need for supplemental screening, CEDM may have a potential role; however, more data on CEDM in the screening setting in intermediate-risk women with dense breast tissue are needed. MRI Breast Without IV Contrast Abbreviated There is no relevant literature regarding the use of AB-MRI breast without IV contrast for supplemental screening in intermediate-risk women with dense breasts. MRI Breast Without and With IV Contrast Abbreviated AB-MRI performed with IV contrast is an abbreviated breast MRI examination. It is similar to a full MRI examination yet does not have a standard protocol; however, at minimum, it must include a precontrast and one postcontrast sequence.