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Can a new breast screening technology find more cancers in women with dense breast tissue? A study managed by the American College of Radiology (ACR) Center for Research and Innovation will compare contrast-enhanced spectral mammography (CESM) to other screening technologies used for dense breasts (those that contain a higher proportion of active tissue than fat). It's difficult to find cancers in dense breast tissue using traditional mammography because the active tissue shows up as white areas on a mammogram, just like cancers do, making abnormalities harder to see.
CESM is similar in some ways to traditional mammography, but before having the usual x-ray, the woman is injected with a special iodine-based contrast agent that highlights abnormal areas on the image more clearly. Cancerous tumors typically create new blood vessels when they form, and the contrast agent can reveal that increased blood flow, alerting the radiologist to a potential cancer.
Some research has found that CESM raises cancer detection rates in dense breast tissue by as much as 70% to 80% compared with traditional screening using mammography. But it's not clear whether this technology is better at finding cancers in dense breasts than the more typical approaches of digital breast tomosynthesis (which creates a three-dimensional image of the breast) and whole breast ultrasound. The trial will aim to find out.
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