Understanding Contrast-Enhanced Mammography


Contrast-enhanced mammography (CEM), also known as contrast-enhanced spectral mammography (CESM) or contrast-enhanced digital mammography (CEDM), is an advanced breast imaging technique that combines traditional mammography with intravenous contrast agents.

The innovative approach offers a more detailed view than traditional mammography to improve the detection and characterization of breast abnormalities, particularly in people with dense breast tissue. It’s also particularly beneficial in identifying and evaluating areas of increased blood supply often associated with tumors. The CEM procedure is similar to a standard mammogram but with the addition of a contrast agent. It is a non-invasive procedure and usually takes about 30 minutes to complete.

Continue reading to learn how contrast-enhanced mammography works, who should consider CEM, the benefits of CEM, and its potential risks and considerations.

How Does Contrast-Enhanced Mammography Work?

CEM involves administering an iodine-based contrast agent during the mammogram. The contrast agent increases the visibility of blood vessels and enhances the contrast between normal and abnormal tissues. The procedure includes taking two sets of mammographic images—one before and one after the contrast injection—allowing radiologists to compare and detect changes more effectively.

Who Should Consider Contrast-Enhanced Mammography?

CEM is particularly useful for:

  • People with dense breast tissue
  • People with inconclusive results from conventional mammography or ultrasound
  • Individuals at high risk for breast cancer
  • Benefits of Contrast-Enhanced Mammography
  • Improved Cancer Detection

One of CEM’s strengths is its enhanced diagnostic capability to detect cancers that may remain undetected in standard mammograms. With traditional mammography, tumors and dense tissue have a similar white appearance, leading to potential misinterpretations or overlooked cancerous lesions.

The contrast agent injected for CEM highlights the cancerous areas more, making it easier to differentiate between benign and malignant lesions. This reduces the need for unnecessary biopsies and provides a more accurate diagnosis and treatment planning.

Accurate and Earlier Diagnosis

CEM provides clearer images, allowing radiologists to detect abnormalities with greater accuracy. It’s particularly important in the early detection of breast cancer, where identifying small tumors can be challenging with standard imaging techniques. Early detection is crucial, as it significantly increases the chances of successful treatment and survival.

Tips for Pain Management with Cancer


Receiving a breast cancer diagnosis and undergoing treatment can be a very painful experience, both physically and emotionally. A good support system and help from loved ones can address the emotional challenges, but not so much the physical ones. These may include:

  • Nerve pain and damage (neuropathy)
  • Lymphedema
  • Infection risk
  • Pain and sensitivity in the skin and nails
  • Reduced mobility while recovering from surgeries

For those experiencing pain during their breast cancer treatment, doctors may prescribe opiates like morphine or oxycodone. However, some people may prefer to avoid opiates, or may be physically unable to take them. This could be because of pre-existing conditions, such as respiratory or kidney issues, or they may be in conflict with other prescription drugs being taken. Thankfully, there are a few alternatives that can help those with cancer alleviate the pain of chemotherapy, surgery, or other treatments.

Continue reading to learn about a variety of pain management techniques and specific considerations for those with cancer.

CBD Products

Cannabidiol (CBD) is one of the key ingredients in cannabis sativa, more commonly known as marijuana. CBD products are not psychoactive, as they do not contain tetrahydrocannabinol (THC) which causes the feeling of being “high,” generally associated with marijuana. For individuals experiencing pain, CBD may provide benefits without mental fogginess or other psychoactive effects.

According to a report published by the National Institutes for Health, studies have shown that creams, oils, edibles, and other products containing CBD can help with pain management for cancer patients while also protecting against damage to the organs or nerves.

Always discuss CBD with your cancer care team to ensure that it is safe for your specific situation and any current treatments.

Nerve Block Procedures

With a nerve block procedure, a numbing agent is injected either directly into or close to a nerve. This has the effect of temporarily blocking pain signals sent by the brain from being received by other parts of the body.

The length of pain relief provided by the block will vary from person to person and depends on a variety of factors. There are many different types of blocks and injection sites used in these procedures. In severe cases, the attending physician may choose to permanently damage the nerve to make sure the pain doesn’t come back.