Background: There are an estimated 4.0 million breast cancer survivors in the United States. Women with a personal history of breast cancer develop a second breast cancer at a rate of 5-10% within 5 to 10 years after initial diagnosis. Therefore, imaging surveillance is performed for women who have breast conserving surgery. Contrast enhanced mammogram (CEM) is a form of mammography that contains both the traditional morphologic data with the addition of physiological information from the contrast injection and dual energy subtraction. There are no formal training requirements for CEM interpretation, however sharing cases and educational presentations will promote learning and increase comfort level in radiologist interpretation. In this exhibit, we present examples of ipsilateral and contralateral breast cancers after breast conserving surgery with a short description of the images, and pathologic findings of the case.
Learning Objectives: Early analysis of clinical outcomes utilizing contrast enhanced mammography exams after breast conserving surgery at an outpatient imaging center.
Provide multiple examples of enhancement features of malignant recurrences on contrast enhanced mammograms.
Evaluate findings and outcomes of lesion identification on ipsilateral and contralateral breast.
Illustrate background parenchymal enhancement levels and how they can affect interpretation.
Abstract Content/Results: A pictorial review of contrast enhanced mammography exams performed on patients who previously underwent breast conserving surgery. 10 - 15 cases will include examples of ipsilateral, lumpectomy bed and contralateral recurrences, post operative seromas, and changes in background parenchymal enhancement levels post radiation exposure.
Conclusion: Contrast enhanced mammography is gaining momentum as an alternative to MRI as a surveillance tool for women who have undergone breast conserving surgery. Providing case reviews and demonstrating performance of the modality will assist in the accuracy of the radiologists that are adopting this technology.
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