Evaluating Suspicious Breast Lesions: A Head-to-Head Comparison of Contrast-Enhanced Mammography and Breast MRI

Background: Magnetic resonance imaging (MRI) is the most sensitive technique for the detection of breast cancer in contemporary medical practice. Contrast-enhanced mammography (CEM), a novel technology, provides a contrast-enhanced imaging alternative to breast MRI. Objectives: to assess the diagnostic efficacy of CEM in the characterization of suspicious breast lesions, with histopathological results serving as the gold standard. Compare CEM with dynamic contrast enhanced MRI (DCE-MRI). Patients and Methods: 30 individuals with suspicious lesions identified using conventional mammography or ultrasonography underwent CEM and DCE-MRI examinations after receiving ethical approval. Proficient radiologists evaluated all discernible lesions using the Breast Imaging Reporting and Data System (BI-RADS) classifications (categories 1–6). Histopathological data were compared to the morphological descriptions of each lesion that were received from each modality. Results: 30 lesions were identified by the combination of breast MRI and CEM in the 30 patients who were enrolled in CEM/MRI investigations. Histopathology verified that 15 of the 30 lesions were malignant and 15 were benign. Twelve of the fifteen malignant lesions were invasive cancers, while three were in situ cancers. Both breast MRI and CEM demonstrated a sensitivity of 93.33%. The specificity of breast MRI was 93.33%, while CEM had a specificity of 80.00%. The breast MRI achieved an accuracy of 93.33%, while the CEM achieved an accuracy of 86.67%. Conclusions: Contrast-enhanced mammography (CEM) has the potential to replace dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as a problem-solving instrument for the characterization of indeterminate breast lesions, particularly in situations where MRI is contraindicated or not promptly accessible. CEM provides a viable alternative for evaluating ambiguous lesions, as it utilizes similar principles of contrast enhancement and tumor vascularity. However, it has the additional benefit of being more broadly available, less expensive, and better tolerated by specific patient populations.