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Contrast-Enhanced Mammography (CEM)
What is a contrast-enhanced mammogram (CEM)?
A contrast-enhanced mammogram (CEM) uses x-rays to take pictures of the breast. A contrast dye is also given through one of the veins in your arm before the pictures are taken. The contrast dye makes it easier to find breast cancer.
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When you get a CEM, you are getting standard mammogram images and contrast-enhanced images at the same time. You do not need to also get a regular mammogram.
How is CEM used at BBDC?
CEM is mainly used at BBDC to help find breast cancers in women who have dense breast tissue, or those at high risk of breast cancer and cannot get breast MRI.
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Women who have dense breast tissue and are currently getting mammography and ultrasound annually can have a single CEM exam performed yearly.
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Women who are at high-risk for breast cancer and getting MRI and mammography, should continue getting these exam or can transition to yearly CEM. This will be reviewed with the radiologist.
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Far less frequently, we can use CEM to help newly evaluate breast cancers when MRI cannot be performed, or when someone has a breast symptom such as a lump or pain.
What happens during a CEM?
A CEM is scheduled for 30 minutes.
The first few minutes are spent filling out paperwork and having your intravenous (IV) line placed. The IV line will be placed in your arm.
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After this, a contrast dye will be given through your IV line. The contrast dye is what helps us find breast cancers. The standard mammogram images are then taken. It will only take 4 -10 minutes to take the pictures.
Many patients report a warm feeling in their pelvis or an urge to urinate after the contrast is given but this quickly goes away.
There are no special preparations. You may eat and drink normally and take routine medications as usual.
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The radiologist will look at all of the images after they are taken and will perform any additional mammogram or ultrasound images, if felt to be necessary. The radiologist will discuss the results with you before you leave BBDC.
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Check out our brochure which walks you through the exam!
Is CEM safe?
Yes!
Both routine mammography and CEM are safe, low radiation dose tests. The radiation dose with CEM is slightly higher than you get with a regular mammography (about 1 ½ times the dose), but it is still low dose, and within the range of what you normally get with a mammogram.
The contrast used in CEM is the same as that used for CT scans and is considered very safe. The main risk is a small chance of an allergic reaction. In general, people at risk for an allergic reaction are those with other severe allergies or those who have had a contrast reaction in the past. The most common reaction is hives, but some people can have a more severe reaction.
Another risk is related to your kidneys. A majority of the contrast dye is removed from the body by the kidneys into the urine. This takes around 24 hours. As a result, it is important that our kidneys are working! If you already have kidney disease, getting contrast dye can also increase your risk for having more kidney injury.
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Our breast imaging team will review your history before you get a CEM to make sure it is safe for you.
Do I need an order for a CEM?
YES!
We need orders to complete any type of breast imaging exam, except for a screening mammogram.
Is CEM covered by insurance?
We have not learned of any issues with coverage.
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CEM is billed as a diagnostic mammogram with contrast. It is often covered by insurance but there still may be a cost to you. Talk to your insurance company to find out more.