Journal of Case Reports and Reviews in Medicine (ISSN: 3069-0749)
Open Access | DOI: 10.64978/JCRRM
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Contrast Enhanced Mammography: A Problem-Solving Tool in Indeterminate Breast Lesions

Dr. Rafia Shahzad*, Dr. Farwa Malik, Dr. Maryam Ikram, Dr. Zeeshan Rashid Mirza, Dr. Faisal Ehsan Cheema, Dr. Arzoo Fatima Saleem

Received : September 01, 2026 | Published : September 28, 2026

Citation: Shahzad R, Malik F, Ikram M, Mirza Z R, Cheema F E, Saleem A F. Contrast Enhanced Mammography: A Problem-Solving Tool in Indeterminate Breast Lesions. J Case Rep Rev Med. 2026;2(3):1-5. doi: 10.64978/jcrrm.2026.09280131

Copyright: © 2026 The Author(s). Published by SCIVOLVE.

License: This article is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) , which permits use, sharing, adaptation, distribution, and reproduction in any medium or format, provided appropriate credit is given to the original author(s) and the source, a link to the Creative Commons licence is provided, and any changes made are indicated.

Abstract

Characterization of breast lesions may remain uncertain with conventional imaging techniques, especially for suspected benign and low-suspicion lesions, which affect decisions about subsequent follow-up or diagnostic biopsy. This study is a cross-sectional diagnostic accuracy study to evaluate the role of Contrast-Enhanced Mammography (CEM) in identifying malignant lesions among 60 female patients aged 20-60 years who have BI-RADS category 3 or 4A lesions on conventional mammography or sonomammography or both. Dual-energy CEM was performed, followed by biopsy or surgical excision of lesions, and the results obtained on histopathology served as the reference standard. Histopathology revealed malignancy in ten of 60 patients (16.7%). CEM classified eleven lesions as malignant and forty-nine as non-malignant, with resulting true-positive, false-positive, false-negative and true-negative results of 9, 2, 1 and 48, respectively. The diagnostic accuracy of CEM, including sensitivity, specificity, PPV, NPV and accuracy rate, was calculated as 90%, 96%, 81.8%, 98% and 95%, respectively, with 95% confidence intervals (CI) for the detection of malignant lesions. CEM also showed positive and negative likelihood ratios of 22.5 and 0.10, respectively. This study demonstrates a high level of diagnostic capability of CEM, especially with a strong predictive power in ruling out malignancy in the studied population. Hence, CEM is considered to be a useful problem-solving tool for the evaluation of BI-RADS category 3 and 4A breast lesions.

Keywords: Breast Cancer; Contrast-Enhanced Mammography; Diagnostic Accuracy; BI-RADS; Breast Lesions; Histopathology.

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