The Reading Room Podcast: A Closer Look at the Impact of Contrast-Enhanced Mammography in Incidence Screening Rounds

Recently published research suggests that contrast-enhanced mammography (CEM) maintains sensitivity from prevalence to incidence screening rounds along with improved specificity.

For the study, recently published in Radiology, researchers reviewed data from 1,575 prevalence screening exams and 5,336 incidence screening exams drawn from a total of 2,756 women (median age of 52). Discussing the study in a recent Reading Room podcast episode, Manisha Bahl, MD, MPH, FSBI, noted no statistically significant difference between screening rounds with respect to sensitivity (86.1 percent vs. 87.1 percent) and cancer detection rate.¹

However, Dr. Bahl pointed out that enhancement on the recombined images facilitated detection for 60 percent of cancers that were occult on low-energy mammogram images.¹

“Importantly, this benefit persisted on subsequent screening rounds. During incidence screening, 58 percent of cancers were detected through enhancement alone. In other words, even after women had undergone prior vascular-based breast imaging, more than half of the cancers detected on subsequent CEM screening would not have been identified on the low-energy mammographic images alone,” explained Dr. Bahl, an associate professor at Harvard Medical School.

The study authors also a statistically significant 8.1 percent increase in specificity for CEM in the incidence screening rounds (91.5 percent vs. 83.4 percent) as well as a 7.9 percent increase in accuracy.¹

"This finding is clinically relevant because one of the concerns with introducing a more sensitive screening modality is the potential increase in false positive findings and unnecessary biopsies. These results suggest that with subsequent CEM rounds and with prior vascular imaging available for comparison, CEM maintains its sensitivity while becoming more specific," noted Dr. Bahl, a breast radiologist affiliated with Massachusetts General Hospital.

For more insights from Dr. Bahl, listen below or subscribe on your favorite podcast platform.

Reference

1. Lee CH, Amir T, Sevilimedu V, et al. Contrast-enhanced mammography for breast cancer screening in women at increased risk: comparison of prevalence and incidence screens. Radiology. 2026;320(1):e252433. doi: 10.1148/radiol.252433.

(Editor’s note: This podcast was originally published as an episode of Dr. Bahl’s Breast Imaging in Focus series at the following link: https://www.diagnosticimaging.com/view/breast-imaging-in-focus-new-research-contrast-enhanced-mammography-prevalence-incidence-screening-rounds .)