Contrast enhanced digital mammography: Is it useful in detecting lesions in edematous breast?

Introduction Breast edema can be caused by a variety of pathologic processes of benign or malignant diseases. Contrast enhanced digital mammogram (CEDM) has been shown to improve the probability of malignancy detection when compared with the conventional mammography alone. Patients and methods This study was prospectively carried on 34 female patients with breast edema at the female imaging unit of the Radiology Department. The age range was 29-80 years. Bilateral conventional mammography (MX) and contrast-enhanced digital mammographic procedure (CEDM) were performed in approximately 7-10 min and followed by complementary ultrasound (US). Results As regards enhancement patterns in our study, noncontrast uptake and diffuse parenchymal uptake were considered as benign and intense contrast uptake is considered malignant and ring enhancement in keeping with both benign and malignant lesions. The calculated sensitivity and specificity of dual energy contrast enhanced digital mammography were 95%, and 73% respectively, with a positive predictive value (PPV) of 88% and negative predictive value (NPV) of 88%. Conclusion Dual-energy contrast-enhanced digital mammography is a useful technique in identification of lesions in mammographically dense edematous breasts and proved to be a useful tool in the follow-up of cases presenting by edema after conservative breast surgery and chemotherapy.