Contrast-enhanced mammography: past, present, and future

Contrast-enhanced mammography (CEM) combines conventional mammography with iodinated contrast material to improve cancer detection. CEM has comparable performance to breast MRI without the added cost or time of conventional MRI protocols. Thus, this technique may be useful for indications previously reserved for MRI, such as problem-solving, determining disease extent in patients with newly diagnosed cancer, monitoring response to neoadjuvant therapy, evaluating the posttreatment breast for residual or recurrent disease, and potentially screening in women at intermediate- or high-risk for breast cancer. This article will provide a comprehensive overview on the past, present, and future of CEM, including its evolving role in the diagnostic and screening settings. •CEM is an emerging imaging technique for breast cancer detection.•CEM has primarily been used in the diagnostic setting.•CEM may have a role in screening intermediate- or high-risk women for breast cancer.•With similar diagnostic performance to MRI, CEM may be a comparable alternative.