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 used 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 but emerging 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 literature regarding the use of mammography with IV contrast for supplemental screening in average-risk women with dense breasts. 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 average-risk women with dense breasts. MRI Breast Without IV Contrast There is no relevant literature regarding the use of MRI breast without IV contrast for supplemental screening in average-risk women with dense breasts. MRI Breast Without and With IV Contrast There are limited data regarding screening average-risk women with breast MRI with and without IV contrast. In a prospective observational trial, after negative mammographic screening, Kuhl et al [33] reported an additional CDR of 15.5/1,000 with MRI screening in average-risk women across all densities. However, the authors did not analyze the added CDR by breast density. FDG-PET Breast Dedicated There is limited relevant literature regarding the use of FDG-PET breast dedicated for supplemental screening in average-risk women with dense breasts [67]. This is not currently widely used in clinical practice.
Supplemental Breast Cancer Screening Based on Breast Density. 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 used 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 but emerging 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 literature regarding the use of mammography with IV contrast for supplemental screening in average-risk women with dense breasts. 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 average-risk women with dense breasts. MRI Breast Without IV Contrast There is no relevant literature regarding the use of MRI breast without IV contrast for supplemental screening in average-risk women with dense breasts. MRI Breast Without and With IV Contrast There are limited data regarding screening average-risk women with breast MRI with and without IV contrast. In a prospective observational trial, after negative mammographic screening, Kuhl et al [33] reported an additional CDR of 15.5/1,000 with MRI screening in average-risk women across all densities. However, the authors did not analyze the added CDR by breast density. FDG-PET Breast Dedicated There is limited relevant literature regarding the use of FDG-PET breast dedicated for supplemental screening in average-risk women with dense breasts [67]. This is not currently widely used in clinical practice.