Contrast-Enhanced Mammography Versus Digital Mammography and Tomosynthesis in Dense Breasts: Diagnostic Accuracy and Impact on Surgical Planning in Multifocal and Multicentric Breast Carcinoma

CEM demonstrated superior diagnostic performance over DM and DBT in women with dense breasts, offering enhanced lesion conspicuity, greater radiologist confidence, and high concordance with histopathology. Its significant impact on surgical planning highlights CEM as a cost-effective, accessible alternative to MRI for preoperative assessment in dense-breast populations, particularly in resource-limited settings.