Detection of a contralateral breast malignancy using contrast-enhanced mammography (CEM) overlooked by initial MRI scan

Contrast-enhanced mammography (CEM) has emerged as a promising technology in the field of breast imaging, experiencing growing acceptance. However, the comparative evaluation of its diagnostic accuracy against MRI remains sparse, largely attributed to its relatively recent introduction. Current studies suggest that MRI and CEM exhibit comparable sensitivity for detecting the index breast lesion. However, there is conflicting evidence regarding their sensitivity in detecting additional breast lesions in cases of known breast cancer, with some studies demonstrating MRI's superiority and others reporting similar sensitivity between the 2 modalities. We present a case where CEM effectively detected a contralateral breast malignancy in a patient with a newly diagnosed breast cancer, whereas it went undetected by MRI initially. Our presentation underscores the importance of more comprehensive research to assess CEM's overall diagnostic capabilities in breast imaging in comparison to MRI, as there may be situations where CEM outperforms MRI.